Cumulative Exposure to Systolic Blood Pressure During Young Adulthood Through Midlife and the Urine Albumin-to-Creatinine Ratio at Midlife

被引：14

作者：

Kramer, Holly ^{[1
,2
]}

Colangelo, Laura ^{[3
]}

Lewis, Cora E. ^{[4
]}

Jacobs, David R., Jr. ^{[5
,6
]}

Pletcher, Mark ^{[7
,8
]}

Bibbins-Domingo, Kirstin ^{[7
,8
,9
]}

Chang, Alex ^{[10
]}

Siscovick, David ^{[11
,12
,13
]}

Shlipak, Michael ^{[14
,15
]}

Peralta, Carmen A. ^{[8
,9
]}

Bansal, Nisha ^{[16
]}

Muntner, Paul ^{[17
]}

Liu, Kiang ^{[3
]}

机构：

[1] Dept Publ Hlth Sci, Div Nephrol & Hypertens, Maywood, IL 60153 USA

[2] Dept Med, Div Nephrol & Hypertens, Maywood, IL 60153 USA

[3] Northwestern Univ, Feinberg Sch Med, Dept Prevent Med, Chicago, IL 60611 USA

[4] Univ Alabama Birmingham, Dept Med, Div Prevent Med, Birmingham, AL 35294 USA

[5] Univ Minnesota, Sch Publ Hlth, Div Epidemiol & Community Hlth, Minneapolis, MN USA

[6] Univ Oslo, Dept Nutr, Oslo, Norway

[7] Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA

[8] Univ Calif San Francisco, Dept Med, San Francisco, CA USA

[9] Univ Calif San Francisco, Dept Med, Div Nephrol, San Francisco, CA USA

[10] Geisinger Hlth Syst, Dept Med, Div Nephrol, Danville, PA USA

[11] New York Acad Med, New York, NY USA

[12] Univ Washington, Seattle Dept Med, Dept Med, Seattle, WA USA

[13] Univ Washington, Seattle Dept Med, Dept Epidemiol, Seattle, WA USA

[14] San Francisco VA Med Ctr, Gen Internal Med Sect, San Francisco, CA USA

[15] Univ Calif San Francisco, San Francisco, CA 94143 USA

[16] Univ Washington, Seattle Dept Med, Div Nephrol, Seattle, WA 98195 USA

[17] Univ Alabama Birmingham, Dept Epidemiol, Birmingham, AL 35233 USA

来源：

AMERICAN JOURNAL OF HYPERTENSION | 2017年 / 30卷 / 05期

关键词：

albumin-to-creatinine ratios; blood pressure; chronic kidney disease; hypertension; microalbuminuria; midlife; race; risk factors; systolic blood pressure; urine albumin excretion; young adulthood; GLOMERULAR-FILTRATION-RATE; ARTERY RISK DEVELOPMENT; COLLABORATIVE METAANALYSIS; HYPERTENSIVE PATIENTS; KIDNEY-DISEASE; CARDIOVASCULAR EVENTS; POPULATION COHORTS; COGNITIVE FUNCTION; CHOLESTEROL LEVELS; MIDDLE-AGE;

D O I：

10.1093/ajh/hpx012

中图分类号：

R6 [外科学];

学科分类号：

1002 ; 100210 ;

摘要：

BACKGROUND Higher blood pressure during young adulthood may increase cardiovascular and kidney disease risk later in life. This study examined the association of cumulative systolic blood pressure (SBP) exposure during young adulthood through midlife with urine albumin-to-creatinine ratios (ACR) measured during midlife. METHODS We used data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, a biracial cohort recruited in 4 urban areas during years 1985-1986. Cumulative SBP was calculated as the average SBP between 2 exams multiplied by years between exams over 20 year years. ACR was measured 20 years after baseline when participants were age 43-50 years (midlife). A generalized additive model was used to examine the association of log ACR as a function of cumulative SBP with adjustment for covariates including SBP measured concurrently with ACR. RESULTS Cumulative SBP ranged from a low of 1,671 to a high of 3,260 mm Hg. Participants in the highest cumulative SBP quartile were more likely to be male (61.4% vs. 20.7%; P < 0.001), Black (61.5% vs. 25.6%; P < 0.001) and have elevated ACR (18.7% vs. 4.8%; P < 0.001) vs. lowest quartile. Spline regression curves of ACR vs. cumulative SBP demonstrated an inflection point in ACR with cumulative SBP levels > 2,350 mm Hg with linear increases in ACR above this threshold. Adjusted geometric mean ACR values were significantly higher with cumulative SBP >= 2,500 vs. < 2500 (9.18 [1.06] vs. 6.92 [1.02]; P < 0.0001). CONCLUSION Higher SBP during young adulthood through midlife is associated with higher ACR during midlife.

引用

页码：502 / 509

页数：8

共 31 条

[1] Blood Pressure Trajectories in Early Adulthood and Subclinical Atherosclerosis in Middle Age [J].