Bidirectional and Temporal Association Between Hypertension and Microalbuminuria: A Longitudinal Study in Chinese Adults

Journal of the American Heart Association - Tập 7 Số 22 - 2018
Mingzhi Zhang1, Yanbo Jiang2, Qiu Zhang3, Yan Chen4, Yan He5, Yao Lin6, Hao Peng7
1Mingzhi Zhang Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
2Yanbo Jiang Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
3Qiu Zhang Department of Chronic Disease Management, Center for Disease Prevention and Control of Gusu District, Suzhou, China
4Yan Chen Department of Nephrology, The Affiliated Jiangyin Hospital of Southeast University Medical College, Jiangyin, China
5Yan He Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
6Yao Lin The State Key Laboratory of Radiation Medicine and Protection, Medical College of Soochow University, Suzhou, China
7Hao Peng Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China

Tóm tắt

Background Although hypertension and microalbuminuria are closely interrelated, the magnitude and temporal sequence of the bidirectional association between hypertension and microalbuminuria are largely unknown. We aimed to delineate the bidirectional and temporal relationship between hypertension and microalbuminuria. Methods and Results Leveraging a longitudinal cohort of Chinese adults who had blood pressure and urinary albumin measured twice 4 years apart, we examined the temporal association between hypertension and microalbuminuria by bidirectional and cross‐lagged panel analysis. All participants were free of cardiovascular disease and chronic kidney disease at baseline. Bidirectional association analysis found that baseline microalbuminuria predicted the risk of incident hypertension (odds ratio=1.75, P =0.028), and baseline blood pressure also significantly predicted the risk of microalbuminuria (odds ratios=1.27 and 1.21 for a per‐SD increase in systolic and diastolic blood pressure, respectively; all P <0.05). Cross‐lagged panel analysis demonstrated a bottom‐line significant relationship of baseline systolic blood pressure to follow‐up urinary albumin ( P =0.079), which is significantly weaker than the other direction of the relationship of baseline urinary albumin to follow‐up blood pressures (all P <0.001). Conclusions These findings indicate a significant bidirectional association between microalbuminuria and hypertension in Chinese adults. Elevated urinary albumin excretion is more likely to precede hypertension. The causality between microalbuminuria and hypertension needs further investigation.

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Tài liệu tham khảo

10.1016/j.ahj.2013.05.008

10.1517/14656566.2012.661716

10.1053/j.ackd.2014.09.001

10.1016/S1474-4422(14)70199-1

10.1093/ndt/gfv009

10.1016/j.jjcc.2010.09.004

10.1253/circj.CJ-10-0444

10.1161/CIRCHEARTFAILURE.109.899070

Brahimi M, Le CH, Ouazen Z, Soufi K, Michault A, Pariès J, Cosson E, Valensi P. Microalbuminuria, a marker of artery rigidity and cardiac dysfunction. Arch Mal Coeur Vaiss. 2007;100:673–676.

10.1097/MD.0000000000000511

10.1186/s12882-017-0603-9

10.1177/1479164113500798

10.1159/000325669

10.1155/2012/951734

10.15171/jnp.2017.33

Said S, Hernandez GT. The link between chronic kidney disease and cardiovascular disease. J Nephropathol. 2014;3:99–104.

10.1053/j.ajkd.2006.07.017

10.4061/2011/747861

10.1007/s40620-016-0335-0

10.1097/MNH.0b013e32836213b8

10.1093/ndt/gfr200

10.3349/ymj.2016.57.6.1454

10.1161/01.HYP.0000154082.72286.2a

10.1161/01.CIR.0000158434.69180.2D

10.1053/j.ajkd.2007.11.010

10.1161/01.HYP.0000167151.52825.11

10.1097/HJH.0b013e32835e2146

10.1093/ajh/hpv002

10.1089/met.2011.0119

Levey AS, Coresh J, Balk E, Kausz AT, Levin A, Steffes MW, Hogg RJ, Perrone RD, Lau J, Eknoyan G.; National Kidney Foundation K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification and stratification. Am J Kidney Dis. 2003;139:137–147.

10.1001/jama.289.19.2560

10.1152/ajpheart.00399.2010

10.18637/jss.v048.i02

10.1097/HJH.0b013e328351856d

10.1161/CIRCULATIONAHA.107.699579

10.1681/ASN.2008010038

10.1038/hr.2012.138

10.1111/j.1524-6175.2006.06032.x

10.1161/01.CIR.94.6.1298

10.1159/000328015

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Journal of the American Heart Association

Tập 7 Số 22

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