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Clinical Epidemiology
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Association of Blood Pressure Trajectories in Early Life with Subclinical Renal Damage in Middle Age

Wenling Zheng, Jianjun Mu, Chao Chu, Jiawen Hu, Yu Yan, Qiong Ma, Yongbo Lv, Xianjing Xu, Keke Wang, Yang Wang, Ying Deng, Bo Yan, Ruihai Yang, Jun Yang, Yong Ren and Zuyi Yuan
JASN December 2018, 29 (12) 2835-2846; DOI: https://doi.org/10.1681/ASN.2018030263
Wenling Zheng
Department of Cardiovascular Medicine, First Affiliated Hospital of Medical College, Xi’an Jiaotong University and Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi’an, People’s Republic of China;
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Jianjun Mu
Department of Cardiovascular Medicine, First Affiliated Hospital of Medical College, Xi’an Jiaotong University and Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi’an, People’s Republic of China;
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Chao Chu
Department of Cardiovascular Medicine, First Affiliated Hospital of Medical College, Xi’an Jiaotong University and Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi’an, People’s Republic of China;
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Jiawen Hu
Department of Cardiovascular Medicine, First Affiliated Hospital of Medical College, Xi’an Jiaotong University and Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi’an, People’s Republic of China;
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Yu Yan
Department of Cardiovascular Medicine, First Affiliated Hospital of Medical College, Xi’an Jiaotong University and Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi’an, People’s Republic of China;
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Qiong Ma
Department of Cardiovascular Medicine, First Affiliated Hospital of Medical College, Xi’an Jiaotong University and Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi’an, People’s Republic of China;
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Yongbo Lv
Department of Cardiovascular Medicine, Second Affiliated Hospital of Medical College, Xi’an Jiaotong University, Xi’an, People’s Republic of China;
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Xianjing Xu
Department of Cardiovascular Medicine, Henan Province People’s Hospital, Zhengzhou, People’s Republic of China;
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Keke Wang
Department of Cardiovascular Medicine, First Affiliated Hospital of Medical College, Xi’an Jiaotong University and Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi’an, People’s Republic of China;
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Yang Wang
Department of Cardiovascular Medicine, First Affiliated Hospital of Medical College, Xi’an Jiaotong University and Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi’an, People’s Republic of China;
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Ying Deng
Department of Cardiovascular Medicine, Hanzhong No. 405 Hospital, Hanzhong, People’s Republic of China;
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Bo Yan
Department of Cardiovascular Medicine, Hanzhong Central Hospital, Hanzhong, People’s Republic of China; and
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Ruihai Yang
Institute of Cardiovascular Sciences, Hanzhong People’s Hospital, Hanzhong, People’s Republic of China
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Jun Yang
Institute of Cardiovascular Sciences, Hanzhong People’s Hospital, Hanzhong, People’s Republic of China
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Yong Ren
Institute of Cardiovascular Sciences, Hanzhong People’s Hospital, Hanzhong, People’s Republic of China
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Zuyi Yuan
Department of Cardiovascular Medicine, First Affiliated Hospital of Medical College, Xi’an Jiaotong University and Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi’an, People’s Republic of China;
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Abstract

Background Although high BP is one of the most important factors affecting renal function, whether longitudinal BP trajectories in early life course are associated with renal function damage in later life is unclear.

Methods To investigate the correlation between BP trajectories from childhood to adulthood and renal function in middle age, we used group-based trajectory models to identify BP trajectories in 2430 individuals (aged 6–15 years old at baseline) participating in the ongoing Hanzhong Adolescent Hypertension Cohort. We tested the association between these trajectories and subclinical renal damage in middle age, adjusting for several covariates.

Results We identified four distinct systolic BP trajectories among 2430 subjects: low stable, moderate stable, high stable, and moderate increasing on the basis of systolic BP levels at baseline and during the 30-year follow-up period. The urinary albumin-to-creatinine ratio (uACR) was higher in moderate stable, high stable, and moderate increasing groups compared with the low stable group. A total of 228 individuals had subclinical renal disease by 2017. Compared with the low stable trajectory group, the other groups had increasingly greater odds of experiencing subclinical renal disease in middle age. These associations were not altered after adjustment for other covariates, except for in the moderate stable group. Analyzed results were similar for the mean arterial pressure and diastolic BP trajectory groups.

Conclusions Higher BP trajectories were correlated with higher of uACR levels and risk of subclinical renal disease in middle age. Identifying long-term BP trajectories from early age may assist in predicting individuals’ renal function in later life.

  • blood pressure trajectory
  • eGFR
  • subclinical renal damage
  • prospective cohort study
  • uACR
  • Copyright © 2018 by the American Society of Nephrology
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Journal of the American Society of Nephrology: 29 (12)
Journal of the American Society of Nephrology
Vol. 29, Issue 12
December 2018
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Association of Blood Pressure Trajectories in Early Life with Subclinical Renal Damage in Middle Age
Wenling Zheng, Jianjun Mu, Chao Chu, Jiawen Hu, Yu Yan, Qiong Ma, Yongbo Lv, Xianjing Xu, Keke Wang, Yang Wang, Ying Deng, Bo Yan, Ruihai Yang, Jun Yang, Yong Ren, Zuyi Yuan
JASN Dec 2018, 29 (12) 2835-2846; DOI: 10.1681/ASN.2018030263

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Association of Blood Pressure Trajectories in Early Life with Subclinical Renal Damage in Middle Age
Wenling Zheng, Jianjun Mu, Chao Chu, Jiawen Hu, Yu Yan, Qiong Ma, Yongbo Lv, Xianjing Xu, Keke Wang, Yang Wang, Ying Deng, Bo Yan, Ruihai Yang, Jun Yang, Yong Ren, Zuyi Yuan
JASN Dec 2018, 29 (12) 2835-2846; DOI: 10.1681/ASN.2018030263
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Keywords

  • blood pressure trajectory
  • eGFR
  • subclinical renal damage
  • prospective cohort study
  • uACR

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