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Abstract：
UNASSIGNED: Unlike systolic blood pressure (SBP), the prognostic value of diastolic blood pressure (DBP) in kidney function has not been established. We hypothesized that pulse pressure (PP), which is associated with arteriosclerosis, would affect the prognostic value of DBP.
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.
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.
摘要：
■与收缩压（SBP）不同，尚未确定舒张压（DBP）对肾功能的预后价值。我们假设脉压(PP)，这与动脉硬化有关，会影响DBP的预后价值。
■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。
■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。
