Hypertension and Prehypertension and Prediction of Development of Decreased Estimated GFR in the General Population: A Meta-analysis of Cohort Studies

摘要: Background Whether blood pressure (BP) plays an independent predictive role in the onset of decreased glomerular filtration rate (GFR) remains ill-defined because existing meta-analyses have incorporated data from studies that included individuals with low GFRs at baseline. This question is critical to optimize chronic kidney disease prevention general population. Study Design Systematic review and meta-analysis longitudinal cohort studies. Setting & Population Adults Selection Criteria for Studies We identified PubMed, EMBASE, Cochrane Library database all evaluating BP incidence estimated GFR (eGFR; defined as eGFR 2 ) without function Predictors Hypertension (BP>140/90mmHg), prehypertension (systolic 120-139 and/or diastolic 80-89mmHg), a continuous variable. Outcomes Risk reported relative risk (RR) 95% CI. Heterogeneity ( I was also evaluated. Results Data 16 cohorts (315,321 participants) were analyzed. All had Newcastle-Ottawa score range 6 8, denoting high quality. During mean follow-up 6.5 years, occurred 6.6% participants. The presence hypertension increased renal (RRs 1.19 [95% CI, 1.07-1.33; =23.8%] 1.76 1.58-1.97; =37.7%], respectively). Similarly, we found every 10–mm Hg increase systolic BPs associated higher 1.08 1.04-1.11; =60.0%] 1.12 1.04-1.20; =51.4%], Metaregression analysis showed greater older age P =0.03), whereas other covariates not significant. Limitations No individual patient-level data. Conclusions Prehypertension hypertension, levels, are predictors population, effect being more pronounced elderly. These findings important improving stratification