Impact of kidney disease and blood pressure on the development of cardiovascular disease: an overview from the Japan...

Area of Science:

• Nephrology
• Cardiology
• Epidemiology

Background:

• Kidney disease is a known risk factor for cardiovascular disease (CVD).
• Prospective studies on this association in Asian populations are limited.
• Lower blood pressure may paradoxically increase CVD risk in individuals with kidney dysfunction.

Purpose of the Study:

• To investigate the relationship between reduced glomerular filtration rate (GFR) and CVD risk in the general Japanese population.
• To examine the association between blood pressure levels and CVD risk across different GFR levels.

Main Methods:

• Analysis of data from 10 community-based cohort studies in Japan.
• Follow-up of 30,657 individuals (aged 40-89) without pre-existing CVD or kidney failure.
• Assessment of CVD incidence based on GFR categories and blood pressure levels, with adjustments for confounding factors.

Main Results:

• A reduced GFR was significantly associated with an increased incidence of CVD.
• Individuals with GFR < 60 mL/min/1.73 m² had a 57% greater risk of CVD compared to those with GFR ≥ 90 mL/min/1.73 m².
• CVD risk increased in a log-linear manner with elevated blood pressure, regardless of GFR levels.

Conclusions:

• Reduced GFR is a significant independent risk factor for CVD in the Japanese population.
• Blood pressure level shows a consistent log-linear association with CVD risk, without a J-curve effect, across all GFR levels.