This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Steven J. Rosansky, MD; Donald R. Hoover, PhD; Lisa King; James Gibson, MD

Arch Intern Med. 1990;150(10):2073-2076.

Abstract
• We compared the changes in serum creatinine levels over time after a mean follow-up of 9.8 years in essential hypertensive (EH, n=56) and control (n=59) male veteran subjects. All subjects had normal serum creatinine levels (62 to 124 µmol/L) and "normal" urinalysis results on entry into the study. Subjects with comorbid renal diagnoses and diabetes mellitus were eliminated from the analysis. Although not statistically significant, the rate of change in the serum creatinine concentration over time was greater in the EH cohort compared with the control cohort (1.08±4.8 vs 0.027±3.5 µmol/L per year). The difference was especially marked in black EH subjects vs black control subjects (1.60 ± 6.2 µmol/L per year vs -0.21 ± 3.3 µmol/L per year). When age, race, body mass index, and a diagnosis of EH were entered into a logistic regression analysis, EH subjects had a statistically significantly greater rate of decline in renal function than did control subjects (1.5 ±8.3 µmol/L per year). When mean time-averaged systolic blood pressure for each subject was also included in the logistic regression analysis, only systolic time-averaged blood pressure was statistically significant (0.063 ± 0.029 µmol/L per year). We conclude that in the absence of clinically detected parenchymal renal disease, EH subjects have a greater rate of decline in renal function than do nonhypertensive subjects. Time-averaged blood pressure is predictive of the change in serum creatinine concentration not only in EH subjects but also in nonhypertensive subjects. Thus, preservation of renal function may require a blood pressure lower than the currently accepted normotensive range.

(Arch Intern Med. 1990;150:2073-2076)

Author Affiliations
From the Medical Service, William Jennings Bryan Dorn Veterans Administration Hospital, Columbia, SC (Dr Rosansky and Ms King); the Department of Epidemiology, The Johns Hopkins University School of Hygiene and Public Health, Baltimore, Md (Dr Hoover); and the Departments of Medicine and Family and Preventive Medicine, University of South Carolina School of Medicine, Columbia (Drs Gibson and Rosansky).

Footnotes
Accepted for publication April 30,1990.

Reprint requests to the Medical Service (111F), William Jennings Bryan Dorn Veterans Administration Hospital, Columbia, SC 29201 (Dr Rosansky).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Essential Hypertension, Progressive Renal Disease, and Uric Acid: A Pathogenetic Link?
Johnson et al.
J. Am. Soc. Nephrol. 2005;16:1909-1919.
ABSTRACT | FULL TEXT  

Blood Pressure Predicts Risk of Developing End-Stage Renal Disease in Men and Women
Tozawa et al.
Hypertension 2003;41:1341-1345.
ABSTRACT | FULL TEXT  

Factors affecting renal function in 119 985 adults over three years
Ishida et al.
QJM 2001;94:541-550.
ABSTRACT | FULL TEXT  

Variation in the progression of diabetic nephropathy according to racial origin
Earle et al.
Nephrol Dial Transplant 2001;16:286-290.
ABSTRACT | FULL TEXT  

Current Strategies for Management of Hypertensive Renal Disease
Moore et al.
Arch Intern Med 1999;159:23-28.
ABSTRACT | FULL TEXT  

Management of chronic renal insufficiency in lupus nephritis: Role of proteinuria, hypertension and dyslipidemia in the progression of renal disease
Clark and Moist
Lupus 1998;7:649-653.
ABSTRACT  

End-stage Renal Disease in Specific Ethnic and Racial Groups: Risk Factors and Benefits of Antihypertensive Therapy
Powers and Wallin
Arch Intern Med 1998;158:793-800.
ABSTRACT | FULL TEXT  

Nitric Oxide in Hypertension: Relationship With Renal Injury and Left Ventricular Hypertrophy
Raij
Hypertension 1998;31:189-193.
ABSTRACT | FULL TEXT  

Effects of Blood Pressure Control on Progressive Renal Disease in Blacks and Whites
Hebert et al.
Hypertension 1997;30:428-435.
ABSTRACT | FULL TEXT  

End-stage Renal Disease in African-American and White Men: 16-Year MRFIT Findings
Klag et al.
JAMA 1997;277:1293-1298.
ABSTRACT  

Serum Creatinine Concentration and Risk of Cardiovascular Disease : A Possible Marker for Increased Risk of Stroke
Wannamethee et al.
Stroke 1997;28:557-563.
ABSTRACT | FULL TEXT  

1995 Update of the Working Group Reports on Chronic Renal Failure and Renovascular Hypertension
National High Blood Pressure Education Program Wor
Arch Intern Med 1996;156:1938-1947.
ABSTRACT  

Blood Pressure and End-Stage Renal Disease in Men
Klag et al.
NEJM 1996;334:13-18.
ABSTRACT | FULL TEXT  

Does Keloid Pathogenesis Hold the Key to Understanding Black/White Differences in Hypertension Severity?
Dustan
Hypertension 1995;26:858-862.
ABSTRACT | FULL TEXT  

Effects of Hypertension and Dyslipidemia on the Decline in Renal Function
Manttari et al.
Hypertension 1995;26:670-675.
ABSTRACT | FULL TEXT  

Blood Pressure and Serum Creatinine
Rosansky
JAMA 1993;269:2983-2983.
ABSTRACT  

Renal Disease in Hypertensive Blacks: MRFIT
Rosansky and Hoover
JAMA 1993;269:2629-2629.
ABSTRACT  

Projections of Hypertension-Related Renal Disease in Middle-aged Residents of the United States
Perneger et al.
JAMA 1993;269:1272-1277.
ABSTRACT  

A Prospective Study of Blood Pressure and Serum Creatinine: Results From the 'Clue' Study and the ARIC Study
Perneger et al.
JAMA 1993;269:488-493.
ABSTRACT