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Abstract: PO1770

ESRD Risk Predicting Using Cumulative Hypertension Burden

Session Information

Category: Hypertension and CVD

  • 1401 Hypertension and CVD: Epidemiology, Risk Factors, and Prevention

Authors

  • Kim, Chang Seong, Chonnam National University Hospital, Gwangju, Gwangju, Korea (the Republic of)
  • Choi, Hong sang, Chonnam National University Hospital, Gwangju, Gwangju, Korea (the Republic of)
  • Bae, Eun Hui, Chonnam National University Hospital, Gwangju, Gwangju, Korea (the Republic of)
  • Ma, Seong Kwon, Chonnam National University Hospital, Gwangju, Gwangju, Korea (the Republic of)
  • Kim, Soo Wan, Chonnam National University Hospital, Gwangju, Gwangju, Korea (the Republic of)
Background

Hypertension is the leading risk factor for end-stage renal disease (ESRD). However, the association between sustained exposure of increased blood pressure (BP) and ESRD is not well-established. This study investigated whether the cumulative hypertension burden is a substantial risk factor for ESRD.

Methods

The incidence of ESRD among 2,144,801 participants identified from the Korean National Health Insurance Service database, who had documented BP assessments for annual health checkup data between 2006 and 2010, was determined. Over a median follow-up of 7.2 years, ESRD was identified in 1,758 participants. Hypertension burden was defined as the cumulative exposure of hypertension (systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg) during 4 consecutive follow up period, and scaled 0 to 4.

Results

Hypertension burden was as follows: 0 (n = 1,164,488), 77.6%; 1 (n = 292,377), 13.6%; 2 (n = 114,397), 5.3%; 3 (n = 52,671), 2.5%; and 4 (n = 20,886), 1.0%. Compared to the hypertension burden of 0, adjusted hazard ratio for ESRD was increased to 1.43, 1.74, 1.85, and 2.70 in hypertension burden of 1, 2, 3, and 4, respectively. A positive dose-dependent relationship between the hypertension burdens and ESRD was found (P for interaction < 0.001). This association was maintained for the sustained exposure of both systolic and diastolic hypertension burden. In conclusion, hypertension burden increases the risk of ESRD.

Conclusion

Our study underlines the usefulness of a new assessment of the hypertension burden over a certain period for predicting the risk of ESRD from a large population-based cohort.