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6. Adiposity and risk of decline in glomerular filtration rate : Meta-analysis of individual participant data in a global consortium

Author

Chang AR, Grams ME, Ballew SH, Bilo H, Correa A, Evans M, Gutierrez OM, Hosseinpanah F, Iseki K, Kenealy T, Klein B, Kronenberg F, Lee BJ, Li Y, Miura K, Navaneethan SD, Roderick PJ, Valdivielso JM, Visseren FLJ, Zhang L, Gansevoort RT, Hallan SI, Levey AS, Matsushita K, Shalev V, Woodward M, Astor B, Appel L, Greene T, Chen T, Chalmers J, Arima H, Perkovic V, Yatsuya H, Tamakoshi K, Hirakawa Y, Coresh J, Sang Y, Polkinghorne K, Chadban S, Atkins R, Levin A, Djurdjev O, Klein R, Lee K, Liu L, Zhao M, Wang F, Wang J, Tang M, Heine G, Emrich I, Zawada A, Bauer L, Nally J, Schold J, Shlipak M, Sarnak M, Katz R, Hiramoto J, Iso H, Yamagishi K, Umesawa M, Muraki I, Fukagawa M, Maruyama S, Hamano T, Hasegawa T, Fujii N, Jafar T, Hatcher J, Poulter N, Chaturvedi N, Wheeler D, Emberson J, Townend J, Landray M, Brenner H, Schöttker B, Saum KU, Rothenbacher D, Fox C, Hwang SJ, Köttgen A, Schneider MP, Eckardt KU, Green J, Kirchner HL, Ito S, Miyazaki M, Nakayama M, Yamada G, Cirillo M, Romundstad S, Øvrehus M, Langlo KA, Irie F, Sairenchi T, Rebholz CM, Young B, Boulware LE, Ishikawa S, Yano Y, Kotani K, Nakamura T, Jee SH, Kimm H, Mok Y, Chodick G, Wetzels JFM, Blankestijn PJ, van Zuilen AD, Bots M, Inker L, Peralta C, Kollerits B, Ritz E, Nitsch D, Fletcher A, Bottinger E, Nadkarni GN, Ellis SB, Nadukuru R, Fernandez E, Betriu A, Bermudez-Lopez M, Stengel B, Metzger M, Flamant M, Houillier P, Haymann JP, Froissart M, Ueshima H, Okayama A, Tanaka S, Okamura T, Elley CR, Collins JF, Drury PL, Ohkubo T, Asayama K, Metoki H, Kikuya M, Iseki C, Nelson RG, Knowler WC, Bakker SJL, Heerspink HJL, Brunskill N, Major R, Shepherd D, Medcalf J, Jassal SK, Bergstrom J, Ix JH, Barrett-Connor E, Kovesdy C, Kalantar-Zadeh K, Sumida K, Muntner P, Warnock D, Judd S, Panwar B, de Zeeuw D, Brenner B, Sedaghat S, Ikram MA, Hoorn EJ, Dehghan A, Wong TY, Sabanayagam C, Cheng CY, Banu R, Segelmark M, Stendahl M, Schön S, Tangri N, Sud M, Naimark D, Wen CP, Tsao CK, Tsai MK, Chen CH, Konta T, Hirayama A, Ichikawa K, Hadaegh F, Mirbolouk M, Azizi F, Solbu MD, Jenssen TG, Eriksen BO, Eggen AE, Lannfelt L, Larsson A, Ärnlöv J, Landman GWD, van Hateren KJJ, Kleefstra N, Chen J, Kwak L, Surapaneni A., Chang, Ar, Grams, Me, Ballew, Sh, Bilo, H, Correa, A, Evans, M, Gutierrez, Om, Hosseinpanah F, Iseki K, Kenealy, T, Klein, B, Kronenberg, F, Lee, Bj, Li, Y, Miura, K, Navaneethan, Sd, Roderick, Pj, Valdivielso, Jm, Visseren, Flj, Zhang, L, Gansevoort, Rt, Hallan, Si, Levey, A, Matsushita, K, Shalev, V, Woodward, M, Astor, B, Appel, L, Greene, T, Chen, T, Chalmers, J, Arima, H, Perkovic, V, Yatsuya, H, Tamakoshi, K, Hirakawa, Y, Coresh, J, Sang, Y, Polkinghorne, K, Chadban, S, Atkins, R, Levin, A, Djurdjev, O, Klein, R, Lee, K, Liu, L, Zhao, M, Wang, F, Wang, J, Tang, M, Heine, G, Emrich, I, Zawada, A, Bauer, L, Nally, J, Schold, J, Shlipak, M, Sarnak, M, Katz, R, Hiramoto, J, Iso, H, Yamagishi, K, Umesawa, M, Muraki, I, Fukagawa, M, Maruyama, S, Hamano, T, Hasegawa, T, Fujii, N, Jafar, T, Hatcher, J, Poulter, N, Chaturvedi, N, Wheeler, D, Emberson, J, Townend, J, Landray, M, Brenner, H, Schöttker, B, Saum, Ku, Rothenbacher, D, Fox, C, Hwang, Sj, Köttgen, A, Schneider, Mp, Eckardt, Ku, Green, J, Kirchner, Hl, Ito, S, Miyazaki, M, Nakayama, M, Yamada, G, Cirillo, M, Romundstad, S, Øvrehus, M, Langlo, Ka, Irie, F, Sairenchi, T, Rebholz, Cm, Young, B, Boulware, Le, Ishikawa, S, Yano, Y, Kotani, K, Nakamura, T, Jee, Sh, Kimm, H, Mok, Y, Chodick, G, Wetzels, Jfm, Blankestijn, Pj, van Zuilen, Ad, Bots, M, Inker, L, Peralta, C, Kollerits, B, Ritz, E, Nitsch, D, Fletcher, A, Bottinger, E, Nadkarni, Gn, Ellis, Sb, Nadukuru, R, Fernandez, E, Betriu, A, Bermudez-Lopez, M, Stengel, B, Metzger, M, Flamant, M, Houillier, P, Haymann, Jp, Froissart, M, Ueshima, H, Okayama, A, Tanaka, S, Okamura, T, Elley, Cr, Collins, Jf, Drury, Pl, Ohkubo, T, Asayama, K, Metoki, H, Kikuya, M, Iseki, C, Nelson, Rg, Knowler, Wc, Bakker, Sjl, Heerspink, Hjl, Brunskill, N, Major, R, Shepherd, D, Medcalf, J, Jassal, Sk, Bergstrom, J, Ix, Jh, Barrett-Connor, E, Kovesdy, C, Kalantar-Zadeh, K, Sumida, K, Muntner, P, Warnock, D, Judd, S, Panwar, B, de Zeeuw, D, Brenner, B, Sedaghat, S, Ikram, Ma, Hoorn, Ej, Dehghan, A, Wong, Ty, Sabanayagam, C, Cheng, Cy, Banu, R, Segelmark, M, Stendahl, M, Schön, S, Tangri, N, Sud, M, Naimark, D, Wen, Cp, Tsao, Ck, Tsai, Mk, Chen, Ch, Konta, T, Hirayama, A, Ichikawa, K, Hadaegh, F, Mirbolouk, M, Azizi, F, Solbu, Md, Jenssen, Tg, Eriksen, Bo, Eggen, Ae, Lannfelt, L, Larsson, A, Ärnlöv, J, Landman, Gwd, van Hateren, Kjj, Kleefstra, N, Chen, J, Kwak, L, Surapaneni, A., Lifestyle Medicine (LM), Cardiovascular Centre (CVC), Groningen Kidney Center (GKC), Groningen Institute for Organ Transplantation (GIOT), Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Asayama, Kei, and Sedaghat, SeyyedMah

Subjects
CHRONIC KIDNEY-DISEASE, Male, 030232 urology & nephrology, 030204 cardiovascular system & hematology, OBESITY PARADOX, Body Mass Index, BMI, eGFR, CKD-PC, Cohort Studies, 0302 clinical medicine, Risk Factors, Urologi och njurmedicin, Medicine, ALL-CAUSE MORTALITY, Adiposity, 2. Zero hunger, Aged, 80 and over, Medicine(all), education.field_of_study, Hazard ratio, ASSOCIATION, General Medicine, Middle Aged, 3. Good health, Cohort, Female, Waist Circumference, Life Sciences & Biomedicine, WAIST CIRCUMFERENCE, Obesity paradox, Glomerular Filtration Rate, Adult, Waist, Population, Renal function, 03 medical and health sciences, Medicine, General & Internal, General & Internal Medicine, CKD, Urology and Nephrology, Humans, Mortality, education, Aged, Science & Technology, business.industry, Research, medicine.disease, Body Height, BODY-MASS INDEX, Kidney Failure, Chronic, WEIGHT, Renal disorders Radboud Institute for Health Sciences [Radboudumc 11], business, Body mass index, Demography, Kidney disease
Abstract

ObjectiveTo evaluate the associations between adiposity measures (body mass index, waist circumference, and waist-to-height ratio) with decline in glomerular filtration rate (GFR) and with all cause mortality.DesignIndividual participant data meta-analysis.SettingCohorts from 40 countries with data collected between 1970 and 2017.ParticipantsAdults in 39 general population cohorts (n=5 459 014), of which 21 (n=594 496) had data on waist circumference; six cohorts with high cardiovascular risk (n=84 417); and 18 cohorts with chronic kidney disease (n=91 607).Main outcome measuresGFR decline (estimated GFR decline ≥40%, initiation of kidney replacement therapy or estimated GFR 2) and all cause mortality.ResultsOver a mean follow-up of eight years, 246 607 (5.6%) individuals in the general population cohorts had GFR decline (18 118 (0.4%) end stage kidney disease events) and 782 329 (14.7%) died. Adjusting for age, sex, race, and current smoking, the hazard ratios for GFR decline comparing body mass indices 30, 35, and 40 with body mass index 25 were 1.18 (95% confidence interval 1.09 to 1.27), 1.69 (1.51 to 1.89), and 2.02 (1.80 to 2.27), respectively. Results were similar in all subgroups of estimated GFR. Associations weakened after adjustment for additional comorbidities, with respective hazard ratios of 1.03 (0.95 to 1.11), 1.28 (1.14 to 1.44), and 1.46 (1.28 to 1.67). The association between body mass index and death was J shaped, with the lowest risk at body mass index of 25. In the cohorts with high cardiovascular risk and chronic kidney disease (mean follow-up of six and four years, respectively), risk associations between higher body mass index and GFR decline were weaker than in the general population, and the association between body mass index and death was also J shaped, with the lowest risk between body mass index 25 and 30. In all cohort types, associations between higher waist circumference and higher waist-to-height ratio with GFR decline were similar to that of body mass index; however, increased risk of death was not associated with lower waist circumference or waist-to-height ratio, as was seen with body mass index.ConclusionsElevated body mass index, waist circumference, and waist-to-height ratio are independent risk factors for GFR decline and death in individuals who have normal or reduced levels of estimated GFR.

Published
2019

8. Association of Office and Ambulatory Blood Pressure With Mortality and Cardiovascular Outcomes

Author

Yang, Wen-Yi, Melgarejo, Jesus D, Thijs, Lutgarde, Zhang, Zhen-Yu, Boggia, Jose, Wei, Fang-Fei, Hansen, Tine W, Asayama, Kei, Ohkubo, Takayoshi, Jeppesen, Jorgen, Dolan, Eamon, Stolarz-Skrzypek, Katarzyna, Malyutina, Sofia, Casiglia, Edoardo, Lind, Lars, Filipovsky, Jan, Maestre, Gladys E, Li, Yan, Wang, Ji-Guang, Imai, Yutaka, Kawecka-Jaszcz, Kalina, Sandoya, Edgardo, Narkiewicz, Krzysztof, O'Brien, Eoin, Verhamme, Peter, Staessen, Jan A, Mujaj, B, Cauwenberghs, N, Kuznetsova, T, Yang, W-Y, Yu, C-G, Sheng, C-S, Huang, Q-F, Seidlerova, J, Ticha, M, Ibsen, H, Rasmussen, S, Torp-Pedersen, C, Pizzioli, A, Tikhonoff, V, Hashimoto, J, Hoshi, H, Inoue, R, Kikuya, M, Metoki, H, Obara, T, Satoh, H, Totsune, K, Gilis-Malinowska, N, Adamkiewicz-Piejko, A, Cwynar, M, Gasowski, J, Grodzicki, T, Lubaszewski, W, Olszanecka, A, Wizner, B, Wojciechowska, W, Zyczkowska, J, Nikitin, Y, Pello, E, Simonova, G, Voevoda, M, Andren, B, Berglund, L, Bjorklund-Bodegard, K, Zethelius, B, Bianchi, M, Moreira, V, Schettini, C, Schwedt, E, Senra, H, RS: CARIM - R3.02 - Hypertension and target organ damage, and RS: Carim - V02 Hypertension and target organ damage

Subjects
Adult, Male, medicine.medical_specialty, Ambulatory blood pressure, PREDICTION, Cost-Benefit Analysis, Population, Blood Pressure, 01 natural sciences, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, Medicine, Humans, CORONARY-HEART-DISEASE, 030212 general & internal medicine, Longitudinal Studies, 0101 mathematics, Risk factor, education, International Database on Ambulatory Blood Pressure in Relation to Cardiovascular Outcomes (IDACO) Investigators, Stroke, Original Investigation, Proportional Hazards Models, RISK, education.field_of_study, HYPERTENSION, business.industry, Proportional hazards model, 010102 general mathematics, Hazard ratio, Blood Pressure Determination, General Medicine, Blood Pressure Monitoring, Ambulatory, Middle Aged, medicine.disease, PREVENTION, Circadian Rhythm, PATTERN, Blood pressure, Cardiovascular Diseases, Cardiology, Female, business, Cohort study
Abstract

IMPORTANCE: Blood pressure (BP) is a known risk factor for overall mortality and cardiovascular (CV)-specific fatal and nonfatal outcomes. It is uncertain which BP index is most strongly associated with these outcomes. OBJECTIVE: To evaluate the association of BP indexes with death and a composite CV event. DESIGN, SETTING, AND PARTICIPANTS: Longitudinal population-based cohort study of 11 135 adults from Europe, Asia, and South America with baseline observations collected from May 1988 to May 2010 (last follow-ups, August 2006-October 2016). EXPOSURES: Blood pressure measured by an observer or an automated office machine; measured for 24 hours, during the day or the night; and the dipping ratio (nighttime divided by daytime readings). MAIN OUTCOMES AND MEASURES: Multivariable-adjusted hazard ratios (HRs) expressed the risk of death or a CV event associated with BP increments of 20/10 mm Hg. Cardiovascular events included CV mortality combined with nonfatal coronary events, heart failure, and stroke. Improvement in model performance was assessed by the change in the area under the curve (AUC). RESULTS: Among 11 135 participants (median age, 54.7 years, 49.3% women), 2836 participants died (18.5 per 1000 person-years) and 2049 (13.4 per 1000 person-years) experienced a CV event over a median of 13.8 years of follow-up. Both end points were significantly associated with all single systolic BP indexes (P

Published
2019

9. Relative risks of Chronic Kidney Disease for mortality and End Stage Renal Disease across races is similar

Author

Wright, Jt, Appel, L, Greene, T, Astor, Bc, Chalmers, J, Macmahon, S, Woodward, M, Arima, H, Yatsuya, H, Yamashita, K, Toyoshima, H, Tamakoshi, K, Coresh, J, Matsushita, K, Atkins, Rc, Polkinghorne, Kr, Chadban, S, Shankar, A, Klein, R, Klein, Be, Lee, Ke, Wang, H, Wang, F, Zhang, L, Zuo, L, Liu, L, Levin, A, Djurdjev, O, Tonelli, M, Sacks, F, Curhan, G, Shlipak, M, Peralta, C, Katz, R, Fried, L, Iso, H, Kitamura, A, Ohira, T, Yamagishi, K, Jafar, Th, Islam, M, Hatcher, J, Poulter, N, Chaturvedi, N, Landray, Mj, Emberson, J, Townend, J, Wheeler, Dc, Rothenbacher, D, Brenner, H, Müller, H, Schöttker, B, Fox, Cs, Hwang, Sj, Meigs, Jb, Perkins, Rm, Fluck, N, Clark, L, Prescott, Gj, Marks, A, Black, C, Cirillo, Massimo, Hallan, S, Aasard, K, Øien, Cm, Radtke, M, Irie, F, Sairenchi, T, Smith, Dh, Weiss, J, Johnson, Es, Thorp, Ml, Collins, Aj, Vassalotti, Ja, Li, S, Chen, Sc, Lee, Bj, Wetzels, Jf, Blankestijn, Pj, Van, Zuilen, Sarnak, M, Levey, As, Inker, L, Menon, V, Fried, Lf, Kramer, H, Boer, De, I, Kronenberg, F, Kollerits, B, Ritz, E, Roderick, P, Nitsch, D, Fletcher, A, Bulpitt, C, Ishani, A, Neaton, J, Froissart, M, Stengel, B, Metzger, M, Haymann, Jp, Houillier, P, Flamant, M, Ohkubo, T, Metoki, H, Nakayama, M, Kikuya, M, Imai, Y, Iseki, K, Nelson, Rg, Knowler, Wc, Gansevoort, Rt, Jong, De, Mahmoodi, Bk, Bakker, Sj, Bernardo, R, Kaur, Jassal, S, Barrett Connor, E, Bergstrom, J, Heerspink, Hj, Brenner, B, Zeeuw, De, D, Warnock, Dg, Muntner, P, Judd, S, Mcclellan, W, Jee, Sh, Kimm, H, Jo, J, Mok, Y, Choi, E, Rossing, P, Parving, Hh, Tangri, N, Naimark, D, Wen, Cp, Wen, Sf, Tsao, Ck, Tsai, Mk, Wu, Be, Ärnlöv, J, Lannfelt, L, Larsson, A, Bilo, Hj, Joosten, H, Kleefstra, N, Groenier, Kh, Drion, I, Hemmelgarn, Br, Ballew, Sh, Grams, M, Sang, Y, Camarata, L, Hui, X, Seltzer, J, Winegrad, H., Cardiovascular Centre (CVC), Groningen Kidney Center (GKC), Wright, Jt, Jr, Appel, L, Greene, T, Astor, Bc, Chalmers, J, Macmahon, S, Woodward, M, Arima, H, Yatsuya, H, Yamashita, K, Toyoshima, H, Tamakoshi, K, Coresh, J, Matsushita, K, Atkins, Rc, Polkinghorne, Kr, Chadban, S, Shankar, A, Klein, R, Klein, Be, Lee, Ke, Wang, H, Wang, F, Zhang, L, Zuo, L, Liu, L, Levin, A, Djurdjev, O, Tonelli, M, Sacks, F, Curhan, G, Shlipak, M, Peralta, C, Katz, R, Fried, L, Iso, H, Kitamura, A, Ohira, T, Yamagishi, K, Jafar, Th, Islam, M, Hatcher, J, Poulter, N, Chaturvedi, N, Landray, Mj, Emberson, J, Townend, J, Wheeler, Dc, Rothenbacher, D, Brenner, H, Müller, H, Schöttker, B, Fox, C, Hwang, Sj, Meigs, Jb, Perkins, Rm, Fluck, N, Clark, L, Prescott, Gj, Marks, A, Black, C, Cirillo, Massimo, Hallan, S, Aasard, K, Øien, Cm, Radtke, M, Irie, F, Sairenchi, T, Smith, Dh, Weiss, J, Johnson, E, Thorp, Ml, Collins, Aj, Vassalotti, Ja, Li, S, Chen, Sc, Lee, Bj, Wetzels, Jf, Blankestijn, Pj, Van, Zuilen, Ad, Sarnak, M, Levey, A, Inker, L, Menon, V, Fried, Lf, Kramer, H, De, Boer, I, Kronenberg, F, Kollerits, B, Ritz, E, Roderick, P, Nitsch, D, Fletcher, A, Bulpitt, C, Ishani, A, Neaton, J, Froissart, M, Stengel, B, Metzger, M, Haymann, Jp, Houillier, P, Flamant, M, Ohkubo, T, Metoki, H, Nakayama, M, Kikuya, M, Imai, Y, Iseki, K, Nelson, Rg, Knowler, Wc, Gansevoort, Rt, De, Jong, Pe, Mahmoodi, Bk, Bakker, Sj, Bernardo, R, Kaur, Jassal, S, Barrett Connor, E, Bergstrom, J, Heerspink, Hj, Brenner, B, De, Zeeuw, D, Warnock, Dg, Muntner, P, Judd, S, Mcclellan, W, Jee, Sh, Kimm, H, Jo, J, Mok, Y, Choi, E, Rossing, P, Parving, Hh, Tangri, N, Naimark, D, Wen, Cp, Wen, Sf, Tsao, Ck, Tsai, Mk, Be, Wu, Ärnlöv, J, Lannfelt, L, Larsson, A, Bilo, Hj, Joosten, H, Kleefstra, N, Groenier, Kh, Drion, I, Hemmelgarn, Br, Ballew, Sh, Grams, M, Sang, Y, Camarata, L, Hui, X, Seltzer, J, and Winegrad, H.

Subjects
Male, GLOMERULAR-FILTRATION-RATE, Cohort Studies, Risk Factors, eGFR, Odds Ratio, ASSOCIATIONS, African Continental Ancestry Group, Aged, 80 and over, education.field_of_study, end-stage renal disease, Hazard ratio, PROTEINURIA, Urology & Nephrology, Middle Aged, CKD-EPI EQUATION, 3. Good health, PREVALENCE, Nephrology, Cardiovascular Diseases, Creatinine, ethnicity, Female, medicine.symptom, epidemiology and outcomes, Glomerular Filtration Rate, Asian Continental Ancestry Group, Adult, medicine.medical_specialty, Population, European Continental Ancestry Group, Renal function, Black People, ALL-CAUSE, Article, White People, End stage renal disease, Asian People, Internal medicine, medicine, Chronic Kidney Disease Prognosis Consortium, Albuminuria, Humans, Renal Insufficiency, Chronic, education, Aged, business.industry, 1103 Clinical Sciences, Odds ratio, POPULATION COHORTS, medicine.disease, INDIVIDUALS, Endocrinology, Relative risk, COLLABORATIVE METAANALYSIS, mortality risk, Kidney Failure, Chronic, Renal disorders Radboud Institute for Health Sciences [Radboudumc 11], business, HIGHER ALBUMINURIA, chronic kidney disease, Kidney disease
Abstract

Item does not contain fulltext Some suggest race-specific cutpoints for kidney measures to define and stage chronic kidney disease (CKD), but evidence for race-specific clinical impact is limited. To address this issue, we compared hazard ratios of estimated glomerular filtration rates (eGFR) and albuminuria across races using meta-regression in 1.1 million adults (75% Asians, 21% Whites, and 4% Blacks) from 45 cohorts. Results came mainly from 25 general population cohorts comprising 0.9 million individuals. The associations of lower eGFR and higher albuminuria with mortality and end-stage renal disease (ESRD) were largely similar across races. For example, in Asians, Whites, and Blacks, the adjusted hazard ratios (95% confidence interval) for eGFR 45-59 versus 90-104 ml/min per 1.73 m(2) were 1.3 (1.2-1.3), 1.1 (1.0-1.2), and 1.3 (1.1-1.7) for all-cause mortality, 1.6 (1.5-1.7), 1.4 (1.2-1.7), and 1.4 (0.7-2.9) for cardiovascular mortality, and 27.6 (11.1-68.7), 11.2 (6.0-20.9), and 4.1 (2.2-7.5) for ESRD, respectively. The corresponding hazard ratios for urine albumin-to-creatinine ratio 30-299 mg/g or dipstick 1+ versus an albumin-to-creatinine ratio under 10 or dipstick negative were 1.6 (1.4-1.8), 1.7 (1.5-1.9), and 1.8 (1.7-2.1) for all-cause mortality, 1.7 (1.4-2.0), 1.8 (1.5-2.1), and 2.8 (2.2-3.6) for cardiovascular mortality, and 7.4 (2.0-27.6), 4.0 (2.8-5.9), and 5.6 (3.4-9.2) for ESRD, respectively. Thus, the relative mortality or ESRD risks of lower eGFR and higher albuminuria were largely similar among three major races, supporting similar clinical approach to CKD definition and staging, across races.

Published
2014

10. Past Decline Versus Current eGFR and Subsequent Mortality Risk

Author

Naimark DMJ, Grams ME, Matsushita K, Black C, Drion I, Fox CS, Inker LA, Ishani A, Jee SA, Kitamura A, Lea JP, Nally J, Peralta CA, Rothenbacher D, Ryu S, Tonelli M, Yatsuya H, Coresh J, Gansevoort RT, Warnock DG, Woodward M, de Jong PE, the CKD Prognosis Consortium, Wright JTJr, Appel LJ, Greene T, MacMahon S, Chalmers J, Arima H, Yamashita K, Toyoshima H, Tamakoshi K, Hemmelgarn B, James M, Sang Y, Atkins RC, Polkinghorne KR, Chadban S, Shankar A, Klein R, Klein BEK, Lee KE, Levin A, Djurdjev O, Sacks FM, Curhan GC, Zawada AM, Rogacev KS, Seiler S, Heine GH, Navaneethan SD, Schold JD, Shlipak M, Sarnak MJ, Katz R, Imano H, Yamagishi K, Wheeler DC, Emberson J, Townend JN, Landray MJ, Brenner H, Müller H, Schöttker B, Hwang S-J, Meigs JB, Uphadhay A, Green J, Kirchner HL, Perkins R, Chang AR, Fluck N, Prescott GJ, Cirillo M, Hallan S, Aasarød K, Øien CM, Radtke M, Irie F, Iso H, Sairenchi T, Smith DH, Thorp ML, Johnson ES, Lee BJ, Guallar E, Chang SY, Cho J, Shin H, Chodick G, Shalev V, Birnbaum YC, Shainberg B, Wetzels JFM, Blankestijn PJ, van Zuilen AD, Levey AS, Neaton JD, Froissart M, Stengel B, Metzger M, Haymann J-P, Houillier P, Flamant M, Elley CR, Kenealy T, Moyes SA, Collins JF, Drury PL, Ohkubo T, Metoki H, Nakayama M, Imai Y, Iseki K, Nelson RG, Knowler WC, Bakker SJL, LHillege H, Jassal SK, Bergstrom J, Ix JH, Barrett-Connor E, Heerspink HJL, Brenner BE, de Zeeuw D, Kimm H, Mok Y, Tangri N, Wen C-P, Wen S-F, Tsao C-K, Tsai M-K, Ärnlöv J, Lannfelt L, Larsson A, Kovesdy CP, Kalantar-Zadeh K, Bilo HJ, Kleefstra N, Groenier KH, Joosten H, Ballew SH, Naimark, Dmj, Grams, Me, Matsushita, K, Black, C, Drion, I, Fox, C, Inker, La, Ishani, A, Jee, Sa, Kitamura, A, Lea, Jp, Nally, J, Peralta, Ca, Rothenbacher, D, Ryu, S, Tonelli, M, Yatsuya, H, Coresh, J, Gansevoort, Rt, Warnock, Dg, Woodward, M, de Jong, Pe, the CKD Prognosis, Consortium, Wright, Jtjr, Appel, Lj, Greene, T, Macmahon, S, Chalmers, J, Arima, H, Yamashita, K, Toyoshima, H, Tamakoshi, K, Hemmelgarn, B, James, M, Sang, Y, Atkins, Rc, Polkinghorne, Kr, Chadban, S, Shankar, A, Klein, R, Klein, Bek, Lee, Ke, Levin, A, Djurdjev, O, Sacks, Fm, Curhan, Gc, Zawada, Am, Rogacev, K, Seiler, S, Heine, Gh, Navaneethan, Sd, Schold, Jd, Shlipak, M, Sarnak, Mj, Katz, R, Imano, H, Yamagishi, K, Wheeler, Dc, Emberson, J, Townend, Jn, Landray, Mj, Brenner, H, Müller, H, Schöttker, B, Hwang, S-J, Meigs, Jb, Uphadhay, A, Green, J, Kirchner, Hl, Perkins, R, Chang, Ar, Fluck, N, Prescott, Gj, Cirillo, M, Hallan, S, Aasarød, K, Øien, Cm, Radtke, M, Irie, F, Iso, H, Sairenchi, T, Smith, Dh, Thorp, Ml, Johnson, E, Lee, Bj, Guallar, E, Chang, Sy, Cho, J, Shin, H, Chodick, G, Shalev, V, Birnbaum, Yc, Shainberg, B, Wetzels, Jfm, Blankestijn, Pj, van Zuilen, Ad, Levey, A, Neaton, Jd, Froissart, M, Stengel, B, Metzger, M, Haymann, J-P, Houillier, P, Flamant, M, Elley, Cr, Kenealy, T, Moyes, Sa, Collins, Jf, Drury, Pl, Ohkubo, T, Metoki, H, Nakayama, M, Imai, Y, Iseki, K, Nelson, Rg, Knowler, Wc, Bakker, Sjl, Lhillege, H, Jassal, Sk, Bergstrom, J, Ix, Jh, Barrett-Connor, E, Heerspink, Hjl, Brenner, Be, de Zeeuw, D, Kimm, H, Mok, Y, Tangri, N, Wen, C-P, Wen, S-F, Tsao, C-K, Tsai, M-K, Ärnlöv, J, Lannfelt, L, Larsson, A, Kovesdy, Cp, Kalantar-Zadeh, K, Bilo, Hj, Kleefstra, N, Groenier, Kh, Joosten, H, Ballew, Sh, Cardiovascular Centre (CVC), and Groningen Kidney Center (GKC)

Subjects
Gerontology, Male, CHRONIC KIDNEY-DISEASE, medicine.medical_specialty, Time Factors, 030232 urology & nephrology, Renal function, 030204 cardiovascular system & hematology, ALL-CAUSE, GLOMERULAR-FILTRATION-RATE, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, Cause of Death, Epidemiology, Risk of mortality, medicine, EQUATION, Humans, Clinical Epidemiology, Renal Insufficiency, Chronic, Aged, Proportional Hazards Models, business.industry, Hazard ratio, STAGE RENAL-DISEASE, DEATH, General Medicine, Middle Aged, POPULATION COHORTS, Confidence interval, Increased risk, Nephrology, CARDIOVASCULAR-DISEASE, COLLABORATIVE METAANALYSIS, Female, business, HIGHER ALBUMINURIA, All cause mortality, Glomerular Filtration Rate
Abstract

A single determination of eGFR associates with subsequent mortality risk. Prior decline in eGFR indicates loss of kidney function, but the relationship to mortality risk is uncertain. We conducted an individual-level meta-analysis of the risk of mortality associated with antecedent eGFR slope, adjusting for established risk factors, including last eGFR, among 1.2 million subjects from 12 CKD and 22 other cohorts within the CKD Prognosis Consortium. Over a 3-year antecedent period, 12% of participants in the CKD cohorts and 11% in the other cohorts had an eGFR slope-5 ml/min per 1.73 m(2) per year, whereas 7% and 4% had a slope5 ml/min per 1.73 m(2) per year, respectively. Compared with a slope of 0 ml/min per 1.73 m(2) per year, a slope of -6 ml/min per 1.73 m(2) per year associated with adjusted hazard ratios for all-cause mortality of 1.25 (95% confidence interval [95% CI], 1.09 to 1.44) among CKD cohorts and 1.15 (95% CI, 1.01 to 1.31) among other cohorts during a follow-up of 3.2 years. A slope of +6 ml/min per 1.73 m(2) per year also associated with higher all-cause mortality risk, with adjusted hazard ratios of 1.58 (95% CI, 1.29 to 1.95) among CKD cohorts and 1.43 (95% CI, 1.11 to 1.84) among other cohorts. Results were similar for cardiovascular and noncardiovascular causes of death and stronger for longer antecedent periods (3 versus3 years). We conclude that prior decline or rise in eGFR associates with an increased risk of mortality, independent of current eGFR.

Published
2016

11. Age and Association of Kidney Measures With Mortality and End-stage Renal Disease

Author

Wright, Jt, Appel, Lj, Greene, T, Astor, Bc, Chalmers, J, Macmahon, S, Woodward, M, Arima, H, Yatsuya, H, Yamashita, K, Toyoshima, H, Tamakoshi, K, Tonelli, M, Hemmelgarn, Br, Bello, A, James, Mt, Coresh, J, Matsushita, K, Sang, Y, Atkins, Rc, Polkinghorne, Kr, Chadban, S, Shankar, A, Klein, R, Klein, Be, Lee, Ke, Wang, H, Wang, F, Zhang, L, Zuo, L, Levin, A, Djurdjev, O, Sacks, Fm, Curhan, Gc, Shlipak, M, Peralta, C, Katz, R, Fried, Lf, Iso, H, Kitamura, A, Ohira, T, Yamagishi, K, Jafar, Th, Islam, M, Hatcher, J, Poulter, N, Chaturvedi, N, Landray, Mj, Emberson, J, Townend, Jn, Wheeler, Dc, Rothenbacher, D, Brenner, H, Müller, H, Schöttker, B, Fox, Cs, Hwang, Sj, Meigs, Jb, Perkins, Rm, Fluck, N, Clark, Le, Prescott, Gj, Marks, A, Black, C, Cirillo, Massimo, Hallan, S, Aasarød, K, Øien, Cm, Radtke, M, Irie, F, Sairenchi, T, Smith, Dh, Weiss, Jw, Johnson, Es, Thorp, Ml, Collins, Aj, Vassalotti, Ja, Li, S, Chen, Sc, Lee, Bj, Wetzels, Jf, Blankestijn, Pj, Van, Zuilen, Sarnak, M, Levey, As, Inker, La, Menon, V, Kramer, Hj, Kronenberg, F, Kollerits, B, Ritz, E, Roderick, P, Nitsch, D, Fletcher, A, Bulpitt, C, Ishani, A, Neaton, Jd, Froissart, M, Stengel, B, Metzger, M, Haymann, Jp, Houillier, P, Flamant, M, Ohkubo, T, Metoki, H, Nakayama, M, Kikuya, M, Imai, Y, Iseki, K, Nelson, Rg, Knowler, Wc, Gansevoort, Rt, Jong, De, Mahmoodi, Bk, Heerspink, Hj, Jassal, Sk, Barrett Connor, E, Bergstrom, J, Brenner, Be, Zeeuw, De, D, Warnock, Dg, Muntner, P, Judd, S, Mcclellan, W, Jee, Sh, Kimm, H, Jo, J, Mok, Y, Lim, Je, Rossing, P, Parving, Hh, Tangri, N, Naimark, D, Wen, Cp, Wen, Sf, Tsao, Ck, Tsai, Mk, Ärnlöv, J, Lannfelt, L, Larsson, A, Bilo, Hj, Joosten, H, Kleefstra, N, Groenier, Kh, Drion, I, Ballew, Sh, Grams, M, Camarata, L, Hui, X, Seltzer, J, Winegrad, H., Cardiovascular Centre (CVC), Groningen Kidney Center (GKC), Wright JT Jr, Appel, Lj, Greene, T, Astor, Bc, Chalmers, J, Macmahon, S, Woodward, M, Arima, H, Yatsuya, H, Yamashita, K, Toyoshima, H, Tamakoshi, K, Tonelli, M, Hemmelgarn, Br, Bello, A, James, Mt, Coresh, J, Matsushita, K, Sang, Y, Atkins, Rc, Polkinghorne, Kr, Chadban, S, Shankar, A, Klein, R, Klein, Be, Lee, Ke, Wang, H, Wang, F, Zhang, L, Zuo, L, Levin, A, Djurdjev, O, Sacks, Fm, Curhan, Gc, Shlipak, M, Peralta, C, Katz, R, Fried, Lf, Iso, H, Kitamura, A, Ohira, T, Yamagishi, K, Jafar, Th, Islam, M, Hatcher, J, Poulter, N, Chaturvedi, N, Landray, Mj, Emberson, J, Townend, Jn, Wheeler, Dc, Rothenbacher, D, Brenner, H, Müller, H, Schöttker, B, Fox, C, Hwang, Sj, Meigs, Jb, Perkins, Rm, Fluck, N, Clark, Le, Prescott, Gj, Marks, A, Black, C, Cirillo, Massimo, Hallan, S, Aasarød, K, Øien, Cm, Radtke, M, Irie, F, Sairenchi, T, Smith, Dh, Weiss, Jw, Johnson, E, Thorp, Ml, Collins, Aj, Vassalotti, Ja, Li, S, Chen, Sc, Lee, Bj, Wetzels, Jf, Blankestijn, Pj, van Zuilen AD, Sarnak, M, Levey, A, Inker, La, Menon, V, Kramer, Hj, Kronenberg, F, Kollerits, B, Ritz, E, Roderick, P, Nitsch, D, Fletcher, A, Bulpitt, C, Ishani, A, Neaton, Jd, Froissart, M, Stengel, B, Metzger, M, Haymann, Jp, Houillier, P, Flamant, M, Ohkubo, T, Metoki, H, Nakayama, M, Kikuya, M, Imai, Y, Iseki, K, Nelson, Rg, Knowler, Wc, Gansevoort, Rt, de Jong PE, Mahmoodi, Bk, Heerspink, Hj, Jassal, Sk, Barrett-Connor, E, Bergstrom, J, Brenner, Be, de Zeeuw, D, Warnock, Dg, Muntner, P, Judd, S, Mcclellan, W, Jee, Sh, Kimm, H, Jo, J, Mok, Y, Lim, Je, Rossing, P, Parving, Hh, Tangri, N, Naimark, D, Wen, Cp, Wen, Sf, Tsao, Ck, Tsai, Mk, Ärnlöv, J, Lannfelt, L, Larsson, A, Bilo, Hj, Joosten, H, Kleefstra, N, Groenier, Kh, Drion, I, Ballew, Sh, Grams, M, Camarata, L, Hui, X, Seltzer, J, and Winegrad, H.

Subjects
Male, BLOOD-PRESSURE, urologic and male genital diseases, Kidney, età, GLOMERULAR-FILTRATION-RATE, Cohort Studies, eGFR, Young adult, Renal disorder [IGMD 9], ALL-CAUSE MORTALITY, GENERAL-POPULATION, insufficienza renale, biology, CYSTATIN C, CARDIOVASCULAR RISK, Age Factors, General Medicine, Middle Aged, female genital diseases and pregnancy complications, RISK POPULATION COHORTS, medicine.anatomical_structure, Female, medicine.symptom, Glomerular Filtration Rate, albuminuria, rischio, mortalità, Adult, Risk, medicine.medical_specialty, Adolescent, Renal function, Context (language use), End stage renal disease, Young Adult, Internal medicine, medicine, Albuminuria, Humans, OLDER-ADULTS, Aged, urogenital system, business.industry, URINARY ALBUMIN EXCRETION, medicine.disease, Endocrinology, Cystatin C, COLLABORATIVE METAANALYSIS, biology.protein, Kidney Failure, Chronic, business, Kidney disease
Abstract

Context Chronic kidney disease (CKD) is prevalent in older individuals, but the risk implications of low estimated glomerular filtration rate (eGFR) and high albuminuria across the full age range are controversial.Objective To evaluate possible effect modification (interaction) by age of the association of eGFR and albuminuria with clinical risk, examining both relative and absolute risks.Design, Setting, and Participants Individual-level meta-analysis including 2 051 244 participants from 33 general population or high-risk (of vascular disease) cohorts and 13 CKD cohorts from Asia, Australasia, Europe, and North/South America, conducted in 1972-2011 with a mean follow-up time of 5.8 years (range, 0-31 years).Main Outcome Measures Hazard ratios (HRs) of mortality and end-stage renal disease (ESRD) according to eGFR and albuminuria were meta-analyzed across age categories after adjusting for sex, race, cardiovascular disease, diabetes, systolic blood pressure, cholesterol, body mass index, and smoking. Absolute risks were estimated using HRs and average incidence rates.Results Mortality (112 325 deaths) and ESRD (8411 events) risks were higher at lower eGFR and higher albuminuria in every age category. In general and high-risk cohorts, relative mortality risk for reduced eGFR decreased with increasing age; eg, adjusted HRs at an eGFR of 45 mL/min/1.73 m(2) vs 80 mL/min/1.73 m(2) were 3.50 (95% CI, 2.55-4.81), 2.21 (95% CI, 2.02-2.41), 1.59 (95% CI, 1.42-1.77), and 1.35 (95% CI, 1.23-1.48) in age categories 18-54, 55-64, 65-74, and >= 75 years, respectively (P Conclusions Both low eGFR and high albuminuria were independently associated with mortality and ESRD regardless of age across a wide range of populations. Mortality showed lower relative risk but higher absolute risk differences at older age.

Published
2012
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12. Paternal height has an impact on birth weight of their offspring in a Japanese population: the Japan Environment and Children's Study.

Author

Takagi, K., Iwama, N., Metoki, H., Uchikura, Y., Matsubara, Y., Matsubara, K., Nishigori, H., Saito, M., Fujiwara, I., Sakurai, K., Kuriyama, S., Arima, T., Nakai, K., Yaegashi, N., and Sugiyama, T.

Abstract

This study examines the relationship between paternal height or body mass index (BMI) and birth weight of their offspring in a Japanese general population. The sample included 33,448 pregnant Japanese women and used fixed data, including maternal, paternal and infant characteristics, from the Japan Environment and Children's Study (JECS), an ongoing nationwide birth cohort study. Relationships between paternal height or BMI and infant birth weight [i.e., small for gestational age (SGA) and large for gestational age (LGA)] were examined using a multinomial logistic regression model. Since fetal programming may be a sex-specific process, male and female infants were analyzed separately. Multivariate analysis showed that the higher the paternal height, the higher the odds of LGA and the lower the odds of SGA in both male and female infants. The effects of paternal BMI on the odds of both SGA and LGA in male infants were similar to those of paternal height; however, paternal height had a stronger impact than BMI on the odds of male LGA. In addition, paternal BMI showed no association with the odds of SGA and only a weak association with the odds of LGA in female infants. This cohort study showed that paternal height was associated with birth weight of their offspring and had stronger effects than paternal BMI, suggesting that the impact of paternal height on infant birth weight could be explained by genetic factors. The sex-dependent effect of paternal BMI on infant birth weight may be due to epigenetic effects. [ABSTRACT FROM AUTHOR]

Published
2019
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14. Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: a collaborative meta-analysis

Author

Chronic Kidney Disease Prognosis Consortium, Matsushita, K, van der Velde, M, Astor, Bc, Woodward, M, Levey, As, de Jong PE, Coresh, J, Investigators/Collaborators: Levey AS, Gansevoort R. T., El Nahas, M, Eckardt, Ku, Kasiske, Bl, Tonelli, M, Hemmelgarn, B, Wang, Y, Atkins, Rc, Polkinghorne, Kr, Chadban, Sj, Shankar, A, Klein, R, Klein, Be, Wang, H, Wang, F, Zhang, L, Liu, L, Shlipak, M, Sarnak, Mj, Katz, R, Fried, Lp, Jafar, T, Islam, M, Hatcher, J, Poulter, N, Chaturvedi, N, Rothenbacher, D, Brenner, H, Raum, E, Koenig, W, Fox, Cs, Hwang, Sj, Meigs, Jb, Cirillo, Massimo, Hallan, S, Lydersen, S, Holmen, J, Roderick, P, Nitsch, D, Fletcher, A, Bulpitt, C, Ohkubo, T, Metoki, H, Nakayama, M, Kikuya, M, Imai, Y, Gansevoort, Rt, Jassal, Sk, Barrett Connor, E, Bergstrom, J, Warnock, Dg, Muntner, P, Judd, S, Mcclellan, Wm, Cushman, M, Howard, G, Mcclure, La, Jee, Sh, Kimm, H, Yun, Je, Wen, Cp, Wen, Sf, Tsao, Ck, Tsai, Mk, Arnlöv, J, Auguste, P, Veldhuis, K, Camarata, L, Thomas, B, Manley, T., Chronic Kidney Disease Prognosis, Consortium, Matsushita, K, van der Velde, M, Astor, Bc, Woodward, M, Levey, A, de Jong, Pe, Coresh, J, Investigators/Collaborators: Levey AS, Gansevoort R. T., El Nahas, M, Eckardt, Ku, Kasiske, Bl, Tonelli, M, Hemmelgarn, B, Wang, Y, Atkins, Rc, Polkinghorne, Kr, Chadban, Sj, Shankar, A, Klein, R, Klein, Be, Wang, H, Wang, F, Zhang, L, Liu, L, Shlipak, M, Sarnak, Mj, Katz, R, Fried, Lp, Jafar, T, Islam, M, Hatcher, J, Poulter, N, Chaturvedi, N, Rothenbacher, D, Brenner, H, Raum, E, Koenig, W, Fox, C, Hwang, Sj, Meigs, Jb, Cirillo, Massimo, Hallan, S, Lydersen, S, Holmen, J, Roderick, P, Nitsch, D, Fletcher, A, Bulpitt, C, Ohkubo, T, Metoki, H, Nakayama, M, Kikuya, M, Imai, Y, Gansevoort, Rt, Jassal, Sk, Barrett Connor, E, Bergstrom, J, Warnock, Dg, Muntner, P, Judd, S, Mcclellan, Wm, Cushman, M, Howard, G, Mcclure, La, Jee, Sh, Kimm, H, Yun, Je, Wen, Cp, Wen, Sf, Tsao, Ck, Tsai, Mk, Arnlöv, J, Auguste, P, Veldhuis, K, Camarata, L, Thomas, B, Manley, T., Cardiovascular Centre (CVC), and Groningen Kidney Center (GKC)

Subjects
Male, CHRONIC KIDNEY-DISEASE, medicine.medical_specialty, Pathology, Population, Urology, Renal function, POOLED ANALYSIS, chemistry.chemical_compound, RISK-FACTOR, CYSTATIN-C, medicine, Risk of mortality, EQUATION, Albuminuria, Humans, Risk factor, Mortality, education, OLDER-ADULTS, Aged, Proportional Hazards Models, Creatinine, education.field_of_study, OUTCOMES, SERUM CREATININE, business.industry, Hazard ratio, General Medicine, Middle Aged, medicine.disease, PREVALENCE, RENAL-DISEASE, chemistry, Cardiovascular Diseases, Chronic Disease, Female, Kidney Diseases, medicine.symptom, business, Kidney disease, Glomerular Filtration Rate
Abstract

BACKGROUND: Substantial controversy surrounds the use of estimated glomerular filtration rate (eGFR) and albuminuria to define chronic kidney disease and assign its stages. We undertook a meta-analysis to assess the independent and combined associations of eGFR and albuminuria with mortality. METHODS: In this collaborative meta-analysis of general population cohorts, we pooled standardised data for all-cause and cardiovascular mortality from studies containing at least 1000 participants and baseline information about eGFR and urine albumin concentrations. Cox proportional hazards models were used to estimate hazard ratios (HRs) for all-cause and cardiovascular mortality associated with eGFR and albuminuria, adjusted for potential confounders. FINDINGS: The analysis included 105,872 participants (730,577 person-years) from 14 studies with urine albumin-to-creatinine ratio (ACR) measurements and 1,128,310 participants (4,732,110 person-years) from seven studies with urine protein dipstick measurements. In studies with ACR measurements, risk of mortality was unrelated to eGFR between 75 mL/min/1.73 m(2) and 105 mL/min/1.73 m(2) and increased at lower eGFRs. Compared with eGFR 95 mL/min/1.73 m(2), adjusted HRs for all-cause mortality were 1.18 (95% CI 1.05-1.32) for eGFR 60 mL/min/1.73 m(2), 1.57 (1.39-1.78) for 45 mL/min/1.73 m(2), and 3.14 (2.39-4.13) for 15 mL/min/1.73 m(2). ACR was associated with risk of mortality linearly on the log-log scale without threshold effects. Compared with ACR 0.6 mg/mmol, adjusted HRs for all-cause mortality were 1.20 (1.15-1.26) for ACR 1.1 mg/mmol, 1.63 (1.50-1.77) for 3.4 mg/mmol, and 2.22 (1.97-2.51) for 33.9 mg/mmol. eGFR and ACR were multiplicatively associated with risk of mortality without evidence of interaction. Similar findings were recorded for cardiovascular mortality and in studies with dipstick measurements. INTERPRETATION: eGFR less than 60 mL/min/1.73 m(2) and ACR 1.1 mg/mmol (10 mg/g) or more are independent predictors of mortality risk in the general population. This study provides quantitative data for use of both kidney measures for risk assessment and definition and staging of chronic kidney disease. FUNDING: Kidney Disease: Improving Global Outcomes (KDIGO), US National Kidney Foundation, and Dutch Kidney Foundation.

Published
2010

15. Risk Stratification by Self-Measured Home Blood Pressure across Categories of Conventional Blood Pressure: A Participant-Level Meta-Analysis

Author

Asayama, K. Thijs, L. Brguljan-Hitij, J. Niiranen, T.J. Hozawa, A. Boggia, J. Aparicio, L.S. Hara, A. Johansson, J.K. Ohkubo, T. Tzourio, C. Stergiou, G.S. Sandoya, E. Tsuji, I. Jula, A.M. Imai, Y. Staessen, J.A. Asayama, K. Ohkubo, T. Kikuya, M. Inoue, R. Satoh, M. Hosaka, M. Utsugi, M.T. Hirose, T. Hara, A. Fukushima, N. Obara, T. Metoki, H. Imai, Y. Johansson, J. Reunanen, A. Jula, A. Ohmori-Matsuda, K. Kuriyama, S. Kakizaki, M. Hozawa, A. Tsuji, I. Mountokalakis, T. Kollias, A. Thomopoulou, G. Kalogeropoulos, P. Skeva, I. Nasothimiou, E. Pantazis, N. Baibas, N. Boggia, J. Sandoya, E. Staessen, J.A. Thijs, L. Cauwenberghs, N. Zhang, Z. Wei, F. Knez, J. Odili, A. Gu, Y. Liu, Y. Jin, Y. Jacobs, L. Kuznetzova, T.

Abstract

Background:The Global Burden of Diseases Study 2010 reported that hypertension is worldwide the leading risk factor for cardiovascular disease, causing 9.4 million deaths annually. We examined to what extent self-measurement of home blood pressure (HBP) refines risk stratification across increasing categories of conventional blood pressure (CBP).Methods and Findings:This meta-analysis included 5,008 individuals randomly recruited from five populations (56.6% women; mean age, 57.1 y). All were not treated with antihypertensive drugs. In multivariable analyses, hazard ratios (HRs) associated with 10-mm Hg increases in systolic HBP were computed across CBP categories, using the following systolic/diastolic CBP thresholds (in mm Hg): optimal

Published
2014

16. Prognostic value of the morning blood pressure surge in 5645 subjects from 8 populations

Author

Li, Y, Thijs, L, Hansen, Tw, Kikuya, M, Boggia, J, Richart, T, Metoki, H, Ohkubo, T, Torp Pedersen, C, Kuznetsova, T, Stolarz Skrzypek, K, Tikhonoff, Valerie, Malyutina, S, Casiglia, Edoardo, Nikitin, Y, Sandoya, E, Kawecka Jaszcz, K, Ibsen, H, Imai, Y, Wang, J, Staessen, Ja, International Database on Ambulatory Blood Pressure Monitoring in Relation to Cardiovascular Outcomes Investigators, Epidemiologie, and RS: CARIM School for Cardiovascular Diseases

Subjects
Male, Questionnaires, medicine.medical_specialty, Percentile, Ambulatory blood pressure, Databases, Factual, blood pressure measurement, 030232 urology & nephrology, Diastole, Blood Pressure, 030204 cardiovascular system & hematology, Article, 03 medical and health sciences, 0302 clinical medicine, population science, Risk Factors, Internal medicine, Surveys and Questionnaires, Internal Medicine, medicine, Humans, ambulatory blood pressure, Morning, business.industry, Incidence, Hazard ratio, Blood Pressure Monitoring, Ambulatory, Middle Aged, Prognosis, 3. Good health, Surgery, Circadian Rhythm, Blood pressure, Cardiovascular Diseases, Ambulatory, Cardiology, Population study, morning surge, epidemiology, Female, business
Abstract

Previous studies on the prognostic significance of the morning blood pressure surge (MS) produced inconsistent results. Using the International Database on Ambulatory Blood Pressure in Relation to Cardiovascular Outcome, we analyzed 5645 subjects (mean age: 53.0 years; 54.0% women) randomly recruited in 8 countries. The sleep-through and the preawakening MS were the differences in the morning blood pressure with the lowest nighttime blood pressure and the preawakening blood pressure, respectively. We computed multivariable-adjusted hazard ratios comparing the risk in ethnic- and sex-specific deciles of the MS relative to the average risk in the whole study population. During follow-up (median: 11.4 years), 785 deaths and 611 fatal and nonfatal cardiovascular events occurred. While accounting for covariables and the night:day ratio of systolic pressure, the hazard ratio of all-cause mortality was 1.32 (95% CI: 1.09 to 1.59; P =0.004) in the top decile of the systolic sleep-through MS (≥37.0 mm Hg). For cardiovascular and noncardiovascular death, these hazard ratios were 1.18 (95% CI: 0.87 to 1.61; P =0.30) and 1.42 (95% CI: 1.11 to 1.80; P =0.005). For all cardiovascular, cardiac, coronary, and cerebrovascular events, the hazard ratios in the top decile of the systolic sleep-through MS were 1.30 (95% CI: 1.06 to 1.60; P =0.01), 1.52 (95% CI: 1.15 to 2.00; P =0.004), 1.45 (95% CI: 1.04 to 2.03; P =0.03), and 0.95 (95% CI: 0.68 to 1.32; P =0.74), respectively. Analysis of the preawakening systolic MS and the diastolic MS generated consistent results. In conclusion, a MS above the 90th percentile significantly and independently predicted cardiovascular outcome and might contribute to risk stratification by ambulatory blood pressure monitoring.

Published
2010

18. Ambulatory versus home versus clinic blood pressure: the association with subclinical cerebrovascular diseases: the Ohasama Study.

Author

Hara A, Tanaka K, Ohkubo T, Kondo T, Kikuya M, Metoki H, Hashimoto T, Satoh M, Inoue R, Asayama K, Obara T, Hirose T, Izumi S, Satoh H, Imai Y, Hara, Azusa, Tanaka, Kazushi, Ohkubo, Takayoshi, Kondo, Takeo, and Kikuya, Masahiro

Abstract

The usefulness of ambulatory, home, and casual/clinic blood pressure measurements to predict subclinical cerebrovascular diseases (silent cerebrovascular lesions and carotid atherosclerosis) was compared in a general population. Data on ambulatory, home, and casual/clinic blood pressures and brain MRI to detect silent cerebrovascular lesions were obtained in 1007 subjects aged ≥55 years in a general population of Ohasama, Japan. Of the 1007 subjects, 583 underwent evaluation of the extent of carotid atherosclerosis. Twenty-four-hour, daytime, and nighttime ambulatory and home blood pressure levels were closely associated with the risk of silent cerebrovascular lesions and carotid atherosclerosis (all P<0.05). When home and one of the ambulatory blood pressure values were simultaneously included in the same regression model, each of the ambulatory blood pressure values remained a significant predictor of silent cerebrovascular lesions, whereas home blood pressure lost its predictive value. Of the ambulatory blood pressure values, nighttime blood pressure was the strongest predictor of silent cerebrovascular lesions. The home blood pressure value was more closely associated with the risk of carotid atherosclerosis than any of the ambulatory blood pressure values when home and one of the ambulatory blood pressure values were simultaneously included in the same regression model. The casual/clinic blood pressure value had no significant association with the risk of subclinical cerebrovascular diseases. Although the clinical indications for ambulatory blood pressure monitoring and home blood pressure measurements may overlap, the clinical significance of each method for predicting target organ damage may differ for different target organs. [ABSTRACT FROM AUTHOR]

Published
2012
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35. Prediction of stroke by self-measurement of blood pressure at home versus casual screening blood pressure measurement in relation to the Joint National Committee 7 classification: the Ohasama study.

Author

Asayama K, Ohkubo T, Kikuya M, Metoki H, Hoshi H, Hashimoto J, Totsune K, Satoh H, Imai Y, Asayama, Kei, Ohkubo, Takayoshi, Kikuya, Masahiro, Metoki, Hirohito, Hoshi, Haruhisa, Hashimoto, Junichiro, Totsune, Kazuhito, Satoh, Hiroshi, and Imai, Yutaka

Published
2004
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