Impact of Multiple Risk Factor Clustering on the Elevation of Blood Pressure.

Tozawa, Masahiko; Iseki, Kunitoshi; Iseki, Chiho; Oshiro, Saori; Higashiuesato, Yasushi; Ikemiya, Yoshiharu; Takishita, Shuichi

doi:10.1291/hypres.25.811

Cited by 14 publications

(12 citation statements)

References 39 publications

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“…This association was independent of well-known risk factors for CKD progression including hypertension [19,20], diabetes, lack of use of RAS inhibitors [21,22], proteinuria [23], baseline eGFR and a steep eGFR slope [24,25] in the multivariate Cox regression analysis. Although, there are 2 reports addressing the association of high eGFR variability with mortality, this is the first report addressing the association of high eGFR variability with a poor renal prognosis.…”

Section: Discussionmentioning

confidence: 94%

Estimated Glomerular Filtration Rate Variability Independently Predicts Renal Prognosis in Advanced Chronic Kidney Disease Patients

Uehara

Yasuda

Shibagaki

et al. 2015

Nephron

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Background: We often experience visit-to-visit estimated glomerular filtration rate (eGFR) variability among patients with advanced chronic kidney disease (CKD). However, the impact of eGFR variability on renal prognosis is not well understood. Methods: The Kanagawa Valsartan Trial was a multicenter, randomized, open-label trial that compared the effect of add-on treatment with angiotensin II receptor blocker, valsartan, with that of conventional treatment on the rate of CKD progression in 293 advanced CKD patients. In this post hoc analysis, we compared the effect of high eGFR variability on end-stage renal disease (ESRD). To evaluate eGFR variability, we chose participants with ≥5 serial measurements of eGFR during the study period and assessed the residual coefficient of variation (CV) of eGFR (residual eGFR-CV) derived from a regression line of eGFR (eGFR slope). The primary end point was the first event of ESRD. Results: Among 237 patients with ≥5 serial measurements of eGFR in a median follow-up of 1.47 years, there were 54 ESRD events in the higher than median residual eGFR-CV group and 36 ESRD events in the lower than median eGFR-CV group (log-rank test, p = 0.008). In multivariate Cox regression analysis, high eGFR variability was significantly associated with the primary end point as well as hypertension, high proteinuria, low baseline eGFR and steep eGFR slope (hazards ratio 2.11, 95% CI 1.33-3.33, p = 0.001). Conclusion: High eGFR variability predicts poor renal prognosis; therefore, further attention is warranted for ambulatory patients with large eGFR fluctuations, especially those with advanced CKD.

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Section: Discussionmentioning

confidence: 94%

Estimated Glomerular Filtration Rate Variability Independently Predicts Renal Prognosis in Advanced Chronic Kidney Disease Patients

Uehara

Yasuda

Shibagaki

et al. 2015

Nephron

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“…Family history of hypertension is associated with increased risk of hypertension (33)(34)(35). Tozawa et al (35) showed in a prospective study that family history of hypertension was a significant predictor of BP elevation.…”

Section: Discussionmentioning

confidence: 99%

Hyperuricemia as a Predictor of Hypertension in a Screened Cohort in Okinawa, Japan

et al. 2004

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Several epidemiological studies have shown a positive association between serum uric acid levels and the risk of hypertension. However, subjects in these studies were mostly men, or were incompletely examined for lifestyle-related variables. We prospectively examined the relation between hyperuricemia and the risk of sociations between the serum uric acid levels and the risk of development of hypertension (5-10). Selby et al. (5) indicated that serum uric acid was closely linked to the development of hypertension and that it might be a marker of susceptibility or an intermediate step in the pathway leading to hypertension. In the Olivetti heart study (6), serum uric acid levels were positively associated with increased risk of hypertension, but analyses were adjusted only for age, body mass index (BMI), serum total cholesterol, and serum triglyceride. Control for confounders such as lifestyle factors was incomplete.In Japan, Nakanishi et al. (7) reported that the risk for development of hypertension over a 6-year period increased progressively as serum uric acid levels increased, even after

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“…The clustering of risk factors such as obesity and metabolic syndrome increases the risk of BP elevation (19). SBP and DBP are known to be significantly associated with inflammatory biomarkers and adipocytokines such as interleukin-6 (IL-6), intercellular adhesion molecule-1 (ICAM-1), leptin, and insulin (20).…”

Section: Discussionmentioning

confidence: 99%

Elevation of Serum C-Reactive Protein Levels Is Associated with Obesity in Boys

et al. 2003

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This study aimed to reveal the relationships among C-reactive protein (CRP), obesity, blood pressure (BP), and serum lipids in children. Eighty-six obese and 58 non-obese boys aged an average of 11.2 years were examined. Serum CRP levels were measured by high sensitivity latex turbidimetric immunoassay and subjects with CRP levels below 0.3 mg/dl were adopted. Comparisons of serum CRP levels, BP, and serum than 10% over the last two decades (2) and this also constitutes a serious public health problem. It is well known that obesity is often associated with metabolic syndromes such as HT, DM, and dyslipidemia. Thus the prevalence of obesityrelated metabolic syndromes can be expected to increase in the near future (3, 4). Clearly, a strategy for preventing obesity will also be needed in children.Recently, many markers of AS have been found, and these are expected to serve as useful indices of prevention and early intervention of coronary events. C-reactive protein (CRP), one of these markers, has been used as an acute phase reac-

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Impact of Multiple Risk Factor Clustering on the Elevation of Blood Pressure.

Cited by 14 publications

References 39 publications

Estimated Glomerular Filtration Rate Variability Independently Predicts Renal Prognosis in Advanced Chronic Kidney Disease Patients

Estimated Glomerular Filtration Rate Variability Independently Predicts Renal Prognosis in Advanced Chronic Kidney Disease Patients

Hyperuricemia as a Predictor of Hypertension in a Screened Cohort in Okinawa, Japan

Elevation of Serum C-Reactive Protein Levels Is Associated with Obesity in Boys

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