Objectives: We examined the following: whether the estimated glomerular filtration rate calculated from the serum cystatin C levels (eGFRcys) and the brachial–ankle pulse wave velocity (baPWV) might be independent predictors of the development of hypertension over the short term, without any interaction; whether the baPWV may be directly associated with the development of hypertension without the mediation of the arterial stiffness-related acceleration of renal functional decline; whether the second peak of the radial pressure waveform (SP2) might also be a significant independent predictor of the development of hypertension.
Methods: In 1229 middle-aged normotensive Japanese men with preserved renal function, the baPWV, SP2 and eGFRcys were measured at the baseline and at the end of the 3-year study period.
Results: Hypertension was detected at the end of the 3-year study period in 127 men. The logistic regression analysis with adjustments demonstrated significant independent odds ratios of the baPWV and eGFRcys for the presence of hypertension at the end of the 3-year study period, without any interaction. When entered simultaneously in this model, the SP2 also showed a significant odds ratio. General linear model analysis revealed that none of the baPWV or SP2 measured at the baseline was related to the renal function assessed at the end of the 3-year study period.
Conclusions: The mechanisms underlying the association between arterial stiffness/central hemodynamics and the short-term development of hypertension appear to differ from those underlying the association between kidney function and the short-term development of hypertension.
aSecond Department of Internal Medicine, Tokyo Medical University, Tokyo, Japan
bUniversity of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, USA
Correspondence to Professor Hirofumi Tomiyama, MD, Second Department of Internal Medicine, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Tokyo, Japan. Tel: +81 3 3342 6111; fax: +81 3 3342 4820; e-mail: email@example.com
Abbreviations: baPWV, brachial–ankle pulse wave velocity; eGFRcr, estimated glomerular filtration rate calculated from the serum creatinine levels; eGFRcys, estimated glomerular filtration rate calculated from the serum cystatin C levels; FPG, fasting plasma glucose; HDL, high-density lipoprotein; rAI, radial augmentation index; SCr, serum creatinine levels; Scys, serum cystatin C levels; SP1, the first peak of the radial pressure waveform; SP2, the second peak of the radial pressure waveform; TC, total cholesterol
Received 29 January, 2013
Revised 4 June, 2013
Accepted 2 August, 2013