UNASSIGNED: This longitudinal study used data from the Japan Specific Health Checkups Study was conducted between 2008 and 2014. The participants were stratified into three PP subgroups (low PP ≤39, normal PP 40-59 and high PP ≥60 mmHg). The exposures of interest were SBP and DBP, and the association between SBP/DBP and kidney outcomes (30% decline in the estimated glomerular filtration rate from baseline) was examined in each PP subgroup using a Cox proportional hazards model.
UNASSIGNED: Among 725 022 participants, 20 414 (2.8%) developed kidney outcomes during a median follow-up period of 34.6 months. Higher SBP was consistently associated with a higher incidence of kidney outcome in all PP subgroups. Although DBP had a positive linear association with the incidence of kidney outcome in low- and normal-PP subgroups, both lower (≤60 mmHg) and higher (≥101 mmHg) DBP were associated with a higher incidence of kidney outcome in the high-PP subgroup, with a U-shaped curve. Hazard ratios (95% confidence intervals) of ≤60 mmHg (reference: 61-80 mmHg in normal-PP subgroup) and ≥101 mmHg were 1.26 (1.15-1.38) and 1.86 (1.62-2.14), respectively.
UNASSIGNED: In this large population-based cohort, DBP was differently associated with kidney outcome by PP level; lower DBP was significantly associated with a higher incidence of kidney outcome in the high-PP subgroup but not in the low- and normal-PP subgroups.
■这项纵向研究使用了2008年至2014年进行的日本特定健康检查研究的数据。将参与者分为三个PP亚组(低PP≤39,正常PP40-59和高PP≥60mmHg)。感兴趣的暴露是SBP和DBP,使用Cox比例风险模型在每个PP亚组中检查了SBP/DBP与肾脏结局之间的相关性(估计肾小球滤过率相对于基线下降30%).
■在725022名参与者中,在34.6个月的中位随访期内,有414例(2.8%)出现了肾脏结局。在所有PP亚组中,较高的SBP与较高的肾脏结局发生率一致相关。尽管DBP与低PP和正常PP亚组的肾脏结局发生率呈线性正相关,在高PP亚组中,较低(≤60mmHg)和较高(≥101mmHg)的DBP与较高的肾脏结局发生率相关,带有U形曲线。≤60mmHg(参考:正常PP亚组中61-80mmHg)和≥101mmHg的危险比(95%置信区间)为1.26(1.15-1.38)和1.86(1.62-2.14),分别。
■在这个以人口为基础的庞大群体中,根据PP水平,DBP与肾脏结局的相关性不同;在高PP亚组中,较低的DBP与较高的肾脏结局发生率显着相关,而在低PP和正常PP亚组中没有。