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Blood Pressure Is a Major Risk Factor for Renal Death: An Analysis of 560 352 Participants From the Asia-Pacific Region

Blood Pressure Is a Major Risk Factor for Renal Death An Analysis of 560 352 Participants From the Asia-Pacific Region Conall M. O'Seaghdha ; Vlado Perkovic ; Tai Hing Lam ; Stella McGinn ; Federica Barzi ; Dong Feng Gu ; Alan Cass ; Il Suh ; Paul Muntner ; Graham G. Giles ; Hirotsugu Ueshima ; Mark... Full description

Journal Title: Hypertension 2009, Vol.54 (3), p.509-515
Main Author: O'Seaghdha, Conall M
Other Authors: Perkovic, Vlado , Lam, Tai Hing , McGinn, Stella , Barzi, Federica , Gu, Dong Feng , Cass, Alan , Suh, Il , Muntner, Paul , Giles, Graham G , Ueshima, Hirotsugu , Woodward, Mark , Huxley, Rachel , on behalf of Asia Pacific Cohort Studies Collaboration
Format: Electronic Article Electronic Article
Language: English
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Publisher: Hagerstown, MD: Am Heart Assoc
ID: ISSN: 0194-911X
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title: Blood Pressure Is a Major Risk Factor for Renal Death: An Analysis of 560 352 Participants From the Asia-Pacific Region
format: Article
creator:
  • O'Seaghdha, Conall M
  • Perkovic, Vlado
  • Lam, Tai Hing
  • McGinn, Stella
  • Barzi, Federica
  • Gu, Dong Feng
  • Cass, Alan
  • Suh, Il
  • Muntner, Paul
  • Giles, Graham G
  • Ueshima, Hirotsugu
  • Woodward, Mark
  • Huxley, Rachel
  • on behalf of Asia Pacific Cohort Studies Collaboration
subjects:
  • Adult
  • Aged
  • Arterial hypertension. Arterial hypotension
  • Asia
  • Australia
  • Biological and medical sciences
  • Blood and lymphatic vessels
  • Blood Glucose - analysis
  • Blood Pressure - physiology
  • Cardiology. Vascular system
  • Cause of Death
  • Cholesterol - blood
  • Cholesterol, HDL - blood
  • Clinical manifestations. Epidemiology. Investigative techniques. Etiology
  • Cohort Studies
  • diabetes mellitus
  • Diabetes Mellitus - blood
  • Diabetes Mellitus - physiopathology
  • Fasting - blood
  • Female
  • Follow-Up Studies
  • Humans
  • hypertension
  • impaired fasting glucose
  • Kidney Failure, Chronic - blood
  • Kidney Failure, Chronic - mortality
  • Kidney Failure, Chronic - physiopathology
  • Male
  • Medical sciences
  • Middle Aged
  • Outcome Assessment (Health Care) - statistics & numerical data
  • Proportional Hazards Models
  • renal mortality
  • Risk Factors
  • Survival Rate
ispartof: Hypertension, 2009, Vol.54 (3), p.509-515
description: Blood Pressure Is a Major Risk Factor for Renal Death An Analysis of 560 352 Participants From the Asia-Pacific Region Conall M. O'Seaghdha ; Vlado Perkovic ; Tai Hing Lam ; Stella McGinn ; Federica Barzi ; Dong Feng Gu ; Alan Cass ; Il Suh ; Paul Muntner ; Graham G. Giles ; Hirotsugu Ueshima ; Mark Woodward ; Rachel Huxley on behalf of the Asia Pacific Cohort Studies Collaboration From the George Institute for International Health (C.M.O., V.P., F.B., A.C., M.W., R.H.), University of Sydney, Australia; the Department of Renal Medicine (C.M.O., V.P., S.M.), Royal North Shore Hospital, Australia; the Department of Community Medicine (T.H.L.), University of Hong Kong, China; the Department of Evidence-Based Medicine (D.F.G.), Fu Wai Hospital, Chinese Academy of Medical Sciences, China; the Yonsei University College of Medicine (I.S.), Korea; the Department of Epidemiology (P.M.), University of Alabama, Birmingham, USA; the Cancer Epidemiology Centre (G.G.G.), Cancer Council of Victoria, Australia; the Department of Health Science (H.U.), Shiga University of Medical Science, Japan; and the Department of Medicine (M.W.), Mount Sinai School of Medicine, New York, NY, USA. Correspondence to Vlado Perkovic, George Institute for International Health, PO Box M201, Level 10, King George V Building, Royal Prince Alfred Hospital, Missenden Rd, Camperdown, Sydney, New South Wales 2050, Australia. E-mail vperkovic{at}george.org.au Chronic kidney disease is a major worldwide public health problem that causes substantial morbidity and mortality. Studies from the Asia-Pacific region have reported some of the highest chronic kidney disease prevalence rates in the world, but access to dialysis is limited in many countries, making it imperative to identify high-risk individuals. We performed a participant-level data overview of prospective studies conducted in the Asia-Pacific region to quantify the magnitude and direction of the associations between putative risk factors and renal death. Age- and sex-adjusted Cox proportional hazards models were applied to pooled data from 35 studies to calculate hazard ratios (95% CIs) for renal death associated with a standardized change in risk factors. Among 560 352 participants followed for a median of 6.8 years, a total of 420 renal deaths were observed. Continuous and positive associations among systolic blood pressure, diastolic blood pressure, fasting blood glucose, and total cholesterol levels with renal death were observed, as wel
language: eng
source:
identifier: ISSN: 0194-911X
fulltext: no_fulltext
issn:
  • 0194-911X
  • 1524-4563
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titleBlood Pressure Is a Major Risk Factor for Renal Death: An Analysis of 560 352 Participants From the Asia-Pacific Region
creatorO'Seaghdha, Conall M ; Perkovic, Vlado ; Lam, Tai Hing ; McGinn, Stella ; Barzi, Federica ; Gu, Dong Feng ; Cass, Alan ; Suh, Il ; Muntner, Paul ; Giles, Graham G ; Ueshima, Hirotsugu ; Woodward, Mark ; Huxley, Rachel ; on behalf of Asia Pacific Cohort Studies Collaboration
creatorcontribO'Seaghdha, Conall M ; Perkovic, Vlado ; Lam, Tai Hing ; McGinn, Stella ; Barzi, Federica ; Gu, Dong Feng ; Cass, Alan ; Suh, Il ; Muntner, Paul ; Giles, Graham G ; Ueshima, Hirotsugu ; Woodward, Mark ; Huxley, Rachel ; on behalf of Asia Pacific Cohort Studies Collaboration ; Asia Pacific Cohort Studies Collaboration
descriptionBlood Pressure Is a Major Risk Factor for Renal Death An Analysis of 560 352 Participants From the Asia-Pacific Region Conall M. O'Seaghdha ; Vlado Perkovic ; Tai Hing Lam ; Stella McGinn ; Federica Barzi ; Dong Feng Gu ; Alan Cass ; Il Suh ; Paul Muntner ; Graham G. Giles ; Hirotsugu Ueshima ; Mark Woodward ; Rachel Huxley on behalf of the Asia Pacific Cohort Studies Collaboration From the George Institute for International Health (C.M.O., V.P., F.B., A.C., M.W., R.H.), University of Sydney, Australia; the Department of Renal Medicine (C.M.O., V.P., S.M.), Royal North Shore Hospital, Australia; the Department of Community Medicine (T.H.L.), University of Hong Kong, China; the Department of Evidence-Based Medicine (D.F.G.), Fu Wai Hospital, Chinese Academy of Medical Sciences, China; the Yonsei University College of Medicine (I.S.), Korea; the Department of Epidemiology (P.M.), University of Alabama, Birmingham, USA; the Cancer Epidemiology Centre (G.G.G.), Cancer Council of Victoria, Australia; the Department of Health Science (H.U.), Shiga University of Medical Science, Japan; and the Department of Medicine (M.W.), Mount Sinai School of Medicine, New York, NY, USA. Correspondence to Vlado Perkovic, George Institute for International Health, PO Box M201, Level 10, King George V Building, Royal Prince Alfred Hospital, Missenden Rd, Camperdown, Sydney, New South Wales 2050, Australia. E-mail vperkovic{at}george.org.au Chronic kidney disease is a major worldwide public health problem that causes substantial morbidity and mortality. Studies from the Asia-Pacific region have reported some of the highest chronic kidney disease prevalence rates in the world, but access to dialysis is limited in many countries, making it imperative to identify high-risk individuals. We performed a participant-level data overview of prospective studies conducted in the Asia-Pacific region to quantify the magnitude and direction of the associations between putative risk factors and renal death. Age- and sex-adjusted Cox proportional hazards models were applied to pooled data from 35 studies to calculate hazard ratios (95% CIs) for renal death associated with a standardized change in risk factors. Among 560 352 participants followed for a median of 6.8 years, a total of 420 renal deaths were observed. Continuous and positive associations among systolic blood pressure, diastolic blood pressure, fasting blood glucose, and total cholesterol levels with renal death were observed, as well as a continuous but inverse association with high-density lipoprotein cholesterol. Systolic blood pressure was the strongest risk factor for renal death with each SD increase in systolic blood pressure (19 mm Hg) associated with >80% higher risk (hazard ratio: 1.84; 95% CI: 1.60 to 2.12). Neither cigarette smoking nor excess weight was related to the risk of renal death ( P >0.10). The results were similar for cohorts in Asia and Australia. These results suggest that primary prevention strategies for renal disease should focus on individuals with elevated blood pressure, diabetes mellitus, and dyslipidemia. Key Words: risk factors • renal mortality • hypertension • diabetes mellitus • impaired fasting glucose Hypertension Home | Subscriptions | Archives | Feedback | Authors | Help | AHA Journals Home | Search Copyright © 2009 American Heart Association, Inc. All rights reserved. Unauthorized use prohibited. var _rsCI="us-lippincott"; var _rsCG="0"; var _rsDN="//secure-us.imrworldwide.com/"; var _rsSE=1; var _rsSM=1.0;
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subjectAdult ; Aged ; Arterial hypertension. Arterial hypotension ; Asia ; Australia ; Biological and medical sciences ; Blood and lymphatic vessels ; Blood Glucose - analysis ; Blood Pressure - physiology ; Cardiology. Vascular system ; Cause of Death ; Cholesterol - blood ; Cholesterol, HDL - blood ; Clinical manifestations. Epidemiology. Investigative techniques. Etiology ; Cohort Studies ; diabetes mellitus ; Diabetes Mellitus - blood ; Diabetes Mellitus - physiopathology ; Fasting - blood ; Female ; Follow-Up Studies ; Humans ; hypertension ; impaired fasting glucose ; Kidney Failure, Chronic - blood ; Kidney Failure, Chronic - mortality ; Kidney Failure, Chronic - physiopathology ; Male ; Medical sciences ; Middle Aged ; Outcome Assessment (Health Care) - statistics & numerical data ; Proportional Hazards Models ; renal mortality ; Risk Factors ; Survival Rate
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2Lam, Tai Hing
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7Suh, Il
8Muntner, Paul
9Giles, Graham G
10Ueshima, Hirotsugu
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12Huxley, Rachel
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0Blood Pressure Is a Major Risk Factor for Renal Death: An Analysis of 560 352 Participants From the Asia-Pacific Region
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descriptionBlood Pressure Is a Major Risk Factor for Renal Death An Analysis of 560 352 Participants From the Asia-Pacific Region Conall M. O'Seaghdha ; Vlado Perkovic ; Tai Hing Lam ; Stella McGinn ; Federica Barzi ; Dong Feng Gu ; Alan Cass ; Il Suh ; Paul Muntner ; Graham G. Giles ; Hirotsugu Ueshima ; Mark Woodward ; Rachel Huxley on behalf of the Asia Pacific Cohort Studies Collaboration From the George Institute for International Health (C.M.O., V.P., F.B., A.C., M.W., R.H.), University of Sydney, Australia; the Department of Renal Medicine (C.M.O., V.P., S.M.), Royal North Shore Hospital, Australia; the Department of Community Medicine (T.H.L.), University of Hong Kong, China; the Department of Evidence-Based Medicine (D.F.G.), Fu Wai Hospital, Chinese Academy of Medical Sciences, China; the Yonsei University College of Medicine (I.S.), Korea; the Department of Epidemiology (P.M.), University of Alabama, Birmingham, USA; the Cancer Epidemiology Centre (G.G.G.), Cancer Council of Victoria, Australia; the Department of Health Science (H.U.), Shiga University of Medical Science, Japan; and the Department of Medicine (M.W.), Mount Sinai School of Medicine, New York, NY, USA. Correspondence to Vlado Perkovic, George Institute for International Health, PO Box M201, Level 10, King George V Building, Royal Prince Alfred Hospital, Missenden Rd, Camperdown, Sydney, New South Wales 2050, Australia. E-mail vperkovic{at}george.org.au Chronic kidney disease is a major worldwide public health problem that causes substantial morbidity and mortality. Studies from the Asia-Pacific region have reported some of the highest chronic kidney disease prevalence rates in the world, but access to dialysis is limited in many countries, making it imperative to identify high-risk individuals. We performed a participant-level data overview of prospective studies conducted in the Asia-Pacific region to quantify the magnitude and direction of the associations between putative risk factors and renal death. Age- and sex-adjusted Cox proportional hazards models were applied to pooled data from 35 studies to calculate hazard ratios (95% CIs) for renal death associated with a standardized change in risk factors. Among 560 352 participants followed for a median of 6.8 years, a total of 420 renal deaths were observed. Continuous and positive associations among systolic blood pressure, diastolic blood pressure, fasting blood glucose, and total cholesterol levels with renal death were observed, as well as a continuous but inverse association with high-density lipoprotein cholesterol. Systolic blood pressure was the strongest risk factor for renal death with each SD increase in systolic blood pressure (19 mm Hg) associated with >80% higher risk (hazard ratio: 1.84; 95% CI: 1.60 to 2.12). Neither cigarette smoking nor excess weight was related to the risk of renal death ( P >0.10). The results were similar for cohorts in Asia and Australia. These results suggest that primary prevention strategies for renal disease should focus on individuals with elevated blood pressure, diabetes mellitus, and dyslipidemia. Key Words: risk factors • renal mortality • hypertension • diabetes mellitus • impaired fasting glucose Hypertension Home | Subscriptions | Archives | Feedback | Authors | Help | AHA Journals Home | Search Copyright © 2009 American Heart Association, Inc. All rights reserved. Unauthorized use prohibited. var _rsCI="us-lippincott"; var _rsCG="0"; var _rsDN="//secure-us.imrworldwide.com/"; var _rsSE=1; var _rsSM=1.0;
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2Arterial hypertension. Arterial hypotension
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4Australia
5Biological and medical sciences
6Blood and lymphatic vessels
7Blood Glucose - analysis
8Blood Pressure - physiology
9Cardiology. Vascular system
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12Cholesterol, HDL - blood
13Clinical manifestations. Epidemiology. Investigative techniques. Etiology
14Cohort Studies
15diabetes mellitus
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17Diabetes Mellitus - physiopathology
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19Female
20Follow-Up Studies
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22hypertension
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25Kidney Failure, Chronic - mortality
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27Male
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30Outcome Assessment (Health Care) - statistics & numerical data
31Proportional Hazards Models
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titleBlood Pressure Is a Major Risk Factor for Renal Death: An Analysis of 560 352 Participants From the Asia-Pacific Region
authorO'Seaghdha, Conall M ; Perkovic, Vlado ; Lam, Tai Hing ; McGinn, Stella ; Barzi, Federica ; Gu, Dong Feng ; Cass, Alan ; Suh, Il ; Muntner, Paul ; Giles, Graham G ; Ueshima, Hirotsugu ; Woodward, Mark ; Huxley, Rachel ; on behalf of Asia Pacific Cohort Studies Collaboration
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abstractBlood Pressure Is a Major Risk Factor for Renal Death An Analysis of 560 352 Participants From the Asia-Pacific Region Conall M. O'Seaghdha ; Vlado Perkovic ; Tai Hing Lam ; Stella McGinn ; Federica Barzi ; Dong Feng Gu ; Alan Cass ; Il Suh ; Paul Muntner ; Graham G. Giles ; Hirotsugu Ueshima ; Mark Woodward ; Rachel Huxley on behalf of the Asia Pacific Cohort Studies Collaboration From the George Institute for International Health (C.M.O., V.P., F.B., A.C., M.W., R.H.), University of Sydney, Australia; the Department of Renal Medicine (C.M.O., V.P., S.M.), Royal North Shore Hospital, Australia; the Department of Community Medicine (T.H.L.), University of Hong Kong, China; the Department of Evidence-Based Medicine (D.F.G.), Fu Wai Hospital, Chinese Academy of Medical Sciences, China; the Yonsei University College of Medicine (I.S.), Korea; the Department of Epidemiology (P.M.), University of Alabama, Birmingham, USA; the Cancer Epidemiology Centre (G.G.G.), Cancer Council of Victoria, Australia; the Department of Health Science (H.U.), Shiga University of Medical Science, Japan; and the Department of Medicine (M.W.), Mount Sinai School of Medicine, New York, NY, USA. Correspondence to Vlado Perkovic, George Institute for International Health, PO Box M201, Level 10, King George V Building, Royal Prince Alfred Hospital, Missenden Rd, Camperdown, Sydney, New South Wales 2050, Australia. E-mail vperkovic{at}george.org.au Chronic kidney disease is a major worldwide public health problem that causes substantial morbidity and mortality. Studies from the Asia-Pacific region have reported some of the highest chronic kidney disease prevalence rates in the world, but access to dialysis is limited in many countries, making it imperative to identify high-risk individuals. We performed a participant-level data overview of prospective studies conducted in the Asia-Pacific region to quantify the magnitude and direction of the associations between putative risk factors and renal death. Age- and sex-adjusted Cox proportional hazards models were applied to pooled data from 35 studies to calculate hazard ratios (95% CIs) for renal death associated with a standardized change in risk factors. Among 560 352 participants followed for a median of 6.8 years, a total of 420 renal deaths were observed. Continuous and positive associations among systolic blood pressure, diastolic blood pressure, fasting blood glucose, and total cholesterol levels with renal death were observed, as well as a continuous but inverse association with high-density lipoprotein cholesterol. Systolic blood pressure was the strongest risk factor for renal death with each SD increase in systolic blood pressure (19 mm Hg) associated with >80% higher risk (hazard ratio: 1.84; 95% CI: 1.60 to 2.12). Neither cigarette smoking nor excess weight was related to the risk of renal death ( P >0.10). The results were similar for cohorts in Asia and Australia. These results suggest that primary prevention strategies for renal disease should focus on individuals with elevated blood pressure, diabetes mellitus, and dyslipidemia. Key Words: risk factors • renal mortality • hypertension • diabetes mellitus • impaired fasting glucose Hypertension Home | Subscriptions | Archives | Feedback | Authors | Help | AHA Journals Home | Search Copyright © 2009 American Heart Association, Inc. All rights reserved. Unauthorized use prohibited. var _rsCI="us-lippincott"; var _rsCG="0"; var _rsDN="//secure-us.imrworldwide.com/"; var _rsSE=1; var _rsSM=1.0;
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