Abstract
To evaluate the influence of proteinuria on the development of hypertension in normotensive screened subjects. We studied 4,428 normotensive subjects without heart disease (2,888 men, 1,540 women, age 19–89 years) who were participants in a 1-day health evaluation in both 1997 and 2000. The 3-year frequency of developing hypertension was 6.0% in subjects without proteinuria, and 13.5% in subjects with proteinuria. The odds ratio for developing hypertension by age (year) increased approximately 1.6%. Obesity was associated with an approximately 40% increased risk of hypertension; proteinuria increased the risk of hypertension 2-fold. Proteinuria was a significant predictor of developing hypertension. Age, obesity, and initial blood pressure level also contributed to the development of hypertension. In conclusion, proteinuria is a powerful predictor of developing hypertension. Age and obesity are also associated with increased risk of hypertension. Lifestyle modification might thus be necessary, particularly in subjects with proteinuria.
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O'Donnell CJ, Ridker PM, Glynn RJ, et al: Hypertension and borderline isolated systolic hypertension increase risks of cardiovascular disease and mortality in male physicians. Circulation 1997; 95: 1132–1137.
Kannel WB : Framingham study insights into hypertensive risk of cardiovascular disease. Hypertens Res 1995; 18: 181–196.
Sagie A, Larson MG, Levy D : The natural history of borderline isolated systolic hypertension. N Engl J Med 1993; 329: 1912–1917.
Iseki K, Kimura Y, Wakugami K, et al: Comparison of the effect of blood pressure on the development of stroke, acute myocardial infarction, and end-stage renal disease. Hypertens Res 2000; 23: 143–149.
Ueda K, Omae T, Hasuo Y, et al: Prognosis and outcome of elderly hypertensives in a Japanese community: results from a long-term prospective study. J Hypertens 1988; 6: 991–997.
Ueda K, Omae T, Hasuo Y, et al: Prevalence and long-term prognosis of mild hypertensives and hypertensives in a Japanese community, Hisayama. J Hypertens 1988; 6: 981–989.
Sarnak MJ, Levey AS, Schoolwerth AC, et al: Kidney disease as a risk factor for development of cardiovascular disease: a statement from the American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention. Circulation 2003; 108: 2154–2169.
Chobanian AV, Bakris GL, Black HR, et al: The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA 2003; 289: 2560–2572.
2003 European Society of Hypertension–European Society of Cardiology guidelines for the management of arterial hypertension. J Hypertens 2003; 21: 1011–1053.
Deckert T, Feldt-Rasmussen B, Borch-Johnsen K, Jensen T, Kofoed-Enevoldsen A : Albuminuria reflects widespread vascular damage. The Steno hypothesis. Diabetologia 1989; 32: 219–226.
Kannel WB, Stampfer MJ, Castelli WP, Verter J : The prognostic significance of proteinuria: the Framingham study. Am Heart J 1984; 108: 1347–1352.
Iseki K, Iseki C, Ikemiya Y, Fukiyama K : Risk of developing end-stage renal disease in a cohort of mass screening. Kidney Int 1996; 49: 800–805.
Cockcroft DW, Gault MH : Prediction of creatinine clearance from serum creatinine. Nephron 1976; 16: 31–41.
DuBois D, DuBois EF : A formula to estimate the approximate surface area if height and weight be known. Arch Intern Med 1916; 17: 863–871.
Vasan RS, Larson MG, Leip EP, Kannel WB, Levy D : Assessment of frequency of progression to hypertension in non-hypertensive participants in the Framingham Heart Study: a cohort study. Lancet 2001; 358: 1682–1686.
Kohara K, Tabara Y, Tachibana R, Nakura J, Miki T : Microalbuminuria and arterial stiffness in a general population: the Shimanami Health Promoting Program (J-SHIPP) study. Hypertens Res 2004; 27: 471–477.
Yudkin JS, Forrest RD, Jackson CA : Microalbuminuria as predictor of vascular disease in non-diabetic subjects. Islington Diabetes Survey. Lancet 1988; 2: 530–533.
Damsgaard EM, Froland A, Jorgensen OD, Mogensen CE : Microalbuminuria as predictor of increased mortality in elderly people. BMJ 1990; 300: 297–300.
Borch-Johnsen K, Feldt-Rasmussen B, Strandgaard S, Schroll M, Jensen JS : Urinary albumin excretion. An independent predictor of ischemic heart disease. Arterioscler Thromb Vasc Biol 1999; 19: 1992–1997.
Knight EL, Kramer HM, Curhan GC : High-normal blood pressure and microalbuminuria. Am J Kidney Dis 2003; 41: 588–595.
Higashiuesato Y, Iseki K, Tozawa M, Chinen OS, Kinjo K, Takishita S : Proteinuria is a significant predictor of development of hypertension. J Am Soc Nephrol 2002; 13: 241A.
Echeverria RF, Carbajal HA, Salazar MR, Riondet B, Rechifort V, Quaini M : Prevalence of high normal blood pressure and progression to hypertension in a population sample of La Plata. Medicina 1992; 52: 145–149.
Miura K : Predictors of the development of hypertension: ten-year follow-up study in a community. Nippon Koshu Eisei Zasshi 1992; 39: 456–466 ( in Japanese).
Miura K, Nakagawa H, Nakamura H, et al: Serum creatinine level in predicting the development of hypertension. Ten-year follow-up of Japanese adults in a rural community. Am J Hypertens 1994; 7: 390–395.
Uchiyama M : Risk factors for the development of essential hypertension: long-term follow-up study in junior high school students in Niigata, Japan. J Hum Hypertens 1994; 8: 323–325.
Nakanishi N, Makino K, Nishina K, Suzuki K, Tatara K : Relationship of light to moderate alcohol consumption and risk of hypertension in Japanese male office workers. Alcohol Clin Exp Res 2002; 26: 988–994.
Ohmori S, Kiyohara Y, Kato I, et al: Alcohol intake and future incidence of hypertension in a general Japanese population: the Hisayama study. Alcohol Clin Exp Res 2002; 26: 1010–1016.
Franklin SS, Gustin Wt, Wong ND, et al: Hemodynamic patterns of age-related changes in blood pressure. The Framingham Heart Study. Circulation 1997; 96: 308–315.
Inoue T, Matsuoka M, Nagahama K, et al: Cardiovascular risk factors associated with pulse pressure in a screened cohort in Okinawa, Japan. Hypertens Res 2003; 26: 153–158.
Miyao M, Furuta M, Sakakibara H, et al: Analysis of factors related to hypertension in Japanese middle-aged male workers. J Hum Hypertens 1992; 6: 193–197.
Stamler J : Epidemiologic findings on body mass and blood pressure in adults. Ann Epidemiol 1991; 1: 347–362.
Kawamura M, Adachi T, Nakajima J, Fujiwara T, Hiramori K : Factors that affect calorie-sensitive and calorie-insensitive reduction in blood pressure during short-term calorie restriction in overweight hypertensive women. Hypertension 1996; 27: 408–413.
Whelton PK, Appel LJ, Espeland MA, et al, TONE Collaborative Research Group: Sodium reduction and weight loss in the treatment of hypertension in older persons: a randomized controlled trial of nonpharmacologic interventions in the elderly (TONE). JAMA 1998; 279: 839–846.
National High Blood Pressure Education Program Working Group: Report on primary prevention of hypertension. Arch Intern Med 1993; 153: 186–208.
Sesso HD, Buring JE, Rifai N, Blake GJ, Gaziano JM, Ridker PM : C-reactive protein and the risk of developing hypertension. JAMA 2003; 290: 2945–2951.
Freitag MH, Larson MG, Levy D, et al: Plasma brain natriuretic peptide levels and blood pressure tracking in the Framingham Heart Study. Hypertension 2003; 41: 978–983.
Vasan RS, Evans JC, Larson MG, et al: Serum aldosterone and the incidence of hypertension in nonhypertensive persons. N Engl J Med 2004; 351: 33–41.
Nagahama K, Iseki K, Inoue T, Touma T, Ikemiya Y, Takishita S : Hyperuricemia and cardiovascular risk factor clustering in a screened cohort in Okinawa, Japan. Hypertens Res 2004; 27: 227–233.
Nagahama K, Inoue T, Iseki K, et al: Hyperuricemia as a predictor of hypertension in a screened cohort in Okinawa, Japan. Hypertens Res 2004; 27: 835–841.
Tozawa M, Oshiro S, Iseki C, et al: Multiple risk factor clustering of hypertension in a screened cohort. J Hypertens 2000; 18: 1379–1385.
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Inoue, T., Iseki, K., Higashiuesato, Y. et al. Proteinuria as a Significant Determinant of Hypertension in a Normotensive Screened Cohort in Okinawa, Japan. Hypertens Res 29, 687–693 (2006). https://doi.org/10.1291/hypres.29.687
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DOI: https://doi.org/10.1291/hypres.29.687
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