Masked Hypertension Determined by Self-Measured Blood Pressure at Home and Chronic Kidney Disease in the Japanese General Population: The Ohasama Study

Both chronic kidney disease (CKD) and masked hypertension (MHT) are known to be linked with an increased risk of cardiovascular disease (CVD), but their relationship has remained unclear. The present study aimed to evaluate the CKD incidence in individuals with MHT in the general Japanese population. We recorded self-measured blood pressure at home (HBP) and casual blood pressure (CBP) in 1,365 individuals (mean 63.0 years old; males, 32.5%; mean creatinine clearance [CCr], 60.9 mL/min; positive proteinuria, 6.7%) and classified the subjects into four groups: sustained normal blood pressure (SNBP, 60.3%), white-coat hypertension (WCHT, 14.9%), MHT (12.8%), and sustained hypertension (SHT, 12.0%). Kidney parameter results for the respective groups (SNBP, WCHT, MHT, and SHT) were as follows: 61.7 mL/min, 61.8 mL/min, 59.6 mL/min, and 57.3 mL/min for CCr, 4.2%, 8.9%, 10.3%, and 12.8% for the prevalence of positive proteinuria, and 2.3%, 3.0%, 6.3%, and 9.8% for the proportion with CCr<60 mL/min with proteinuria. Compared with the SNBP group, the MHT and SHT groups exhibited significant differences in these parameters (p<0.05, for each). The adjusted odds ratios for CCr<60 mL/min with proteinuria were significantly higher in the MHT (2.56) and SHT (3.60) groups compared with the SNBP group (reference). MHT, like SHT, is closely related to CKD, and HBP measurement could be a useful screening strategy to detect CKD in the general population.