血圧と血清クレアチニンの前向きな研究. "ヒント"研究とARIC研究の結果
T V Perneger1, F J Nieto, P K Whelton
1Department of Epidemiology, Johns Hopkins University School of Hygiene and Public Health, Baltimore, Md.
JAMA
|January 27, 1993
まとめ
過去の血圧レベルは,正常なレベルであっても,現在のレベルよりも血清クレアチニンとハイパークレアチネミアのより良い予測指標です. これは,高血圧が時間の経過とともに腎臓の早期損傷を引き起こす可能性があることを示唆しています.
科学分野:
- ネフロロジーはネフロロジーを用います.
- 心血管医学 心血管医学
- エピデミオロジー エピデミオロジー
背景:
- 血清クレアチニンのレベルは,腎臓機能の重要な指標である.
- 高血圧は慢性腎臓病の主要な危険因子です.
- 血圧と腎臓マーカーの長期的な関係を理解することは,公衆衛生にとって極めて重要です.
研究 の 目的:
- 一般集団における過去のおよび現在の血圧レベルと血清クレアチニンレベルとの関連性を調査する.
- 過去の血圧が現在の血圧よりも腎機能マーカーのより良い予測力であるかどうかを判断する.
主な方法:
- メリーランド州ワシントン郡の1399人の中年成人を対象とした非同期的な前向きな研究です.
- 血圧は1974年に測定され,1986年から1989年にかけて再び測定された.
- 血清クレアチニン濃度と高クレアチニン血症は1986年から1989年の間に評価され,リグレッションモデルを用いて関連性を分析した.
主要な成果:
- 過去の血圧 (1974年) は,現在の血圧 (1986年 - 1989年) よりも血清クレアチニンと超クレアチニン症 (1986年 - 1989年) の有力な予測指標でした.
- 1974年に血圧が20mmHg上昇すると,高クレアチネミアの確率が1.5~2倍に増加した.
- 血圧とクレアチニンの間の関連性は,高血圧でないレベルでも有意であった.
結論:
- 血圧と血清クレアチニンのレベルは,一般人群では有意に関連しています.
- この関連性は,血圧とクレアチニン測定の間の時間遅れがある場合により強くなります.
- 高血圧は高血圧の値以下であっても,早期の腎臓損傷に寄与する可能性があります.
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