Journal
HYPERTENSION RESEARCH
Volume 44, Issue 12, Pages 1652-1661Publisher
SPRINGERNATURE
DOI: 10.1038/s41440-021-00723-0
Keywords
Blood Pressure; Hypertension; Burden; Kidney failure; Chronic; National Health Programs
Categories
Funding
- Korea Health Technology R&D Project through the Korea Health Industry Development Institute - Ministry of Health & Welfare, Republic of Korea [HI18C0331, HR20C0021, BCRI20062, BCRI21023]
- Chonnam National University Hospital Biomedical Research Institute
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Hypertension burden is positively associated with an increased risk of end-stage renal disease (ESRD), with a dose-dependent relationship between the two. Assessing hypertension burden over a certain period may be useful in predicting the risk of ESRD in large population-based cohorts.
Hypertension is the leading risk factor for end-stage renal disease (ESRD). However, the association between sustained exposure to increased blood pressure (BP) and ESRD is not well established. This study investigated whether the cumulative hypertension burden is a substantial risk factor for ESRD. The incidence of ESRD among 2,144,801 participants identified from the Korean National Health Insurance Service database who had documented BP assessment data in their annual health check-up data from between 2006 and 2010, was determined. Over a median follow-up of 7.2 years, ESRD was identified in 1758 participants. Hypertension burden was defined as the cumulative exposure to hypertension (systolic BP >= 140 mmHg or diastolic BP >= 90 mmHg) during four consecutive follow-up periods and ranged from 0 to 4. The hypertension burden was as follows: 0 (n = 1,164,488), 77.6%; 1 (n = 292,377), 13.6%; 2 (n = 114,397), 5.3%; 3 (n = 52,671), 2.5%; and 4 (n = 20,886), 1.0%. Compared to the hypertension burden of 0, the adjusted hazard ratio for ESRD was 1.35, 1.54, 1.51, and 2.28 for hypertension burdens of 1, 2, 3, and 4, respectively. A positive dose-dependent relationship between hypertension burden and ESRD was found (P for interaction < 0.001). This association was maintained for sustained exposure to both systolic and diastolic hypertension burden. In conclusion, hypertension burden increases the risk of ESRD. Our study underlines the usefulness of a new assessment of the hypertension burden over a certain period for predicting the risk of ESRD in a large population-based cohort.
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