Association between blood pressure and new onset of chronic kidney disease in non-diabetic Japanese adults: a population-based longitudinal study from 1998 to 2023

Abstract

AbstractHypertension is a risk factor for developing chronic kidney disease (CKD). Studies of adult participants in the USA reported that hypertension increased the risk of developing CKD even in the non-diabetic population. However, studies in non-diabetic populations are limited and additional studies in other races are required. This longitudinal study (1998–2023) aimed to evaluate the relationship between blood pressure (BP) levels and subsequent development of CKD in non-diabetic Japanese adults. CKD was defined as 60 mL/min/1.73 m2, and hypertension was classified into four levels according to the guidelines of the American College of Cardiology/American Heart Association. The Weibull accelerated failure time model was selected to estimate the effects of covariates on the survival time because the proportional hazard assumption was violated. Of the 7 363 (men: 40.3%) people in the final cohort, 2 498 (men: 40.1%) developed CKD after a mean follow-up of 7.99 person-years. Participants with elevated BP (systolic blood pressure [SBP] of 120–129 mmHg and diastolic blood pressure [DBP] <80 mmHg) and hypertension stage 2 (SBP ≥140 mmHg or DBP ≥90 mmHg) had a 9% (95% confidence interval [CI]: 1%–16%) and 11% (95% CI: 5%–17%) shorter survival time to CKD onset, respectively, than those with normal BP (SBP <120 mmHg and DBP <80 mmHg). However, hypertension stage 1 (SBP of 130–139 mmHg or DBP of 80–89 mmHg) was not associated with CKD onset. Therefore, in a relatively healthy Asian population, controlling BP to an appropriate range reduces the risk of developing CKD.