Prehypertension Ups End-Stage Renal Disease Risk

Prehypertension, especially in the high range, is associated with an increased likelihood of end-stage renal disease (ESRD), a recent study suggests.

Researchers conducted a systematic review and meta-analysis of data from more than 1 million patients in six prospective cohort studies and found that prehypertension significantly increased the risk of ESRD by 59% compared with optimal blood pressure (BP), defined as BP below 120/80 mm Hg, according to a report published online ahead of print in the American Journal of Kidney Diseases.

The study by Yuli Huang, MD, of Southern Medical University in Guangzhou, China, and collaborators demonstrated that a BP of 130-139/85-89 mm Hg was associated with a twofold increased risk of ESRD compared with optimal BP. Even low-range prehypertension increased the risk of ESRD: individuals with a BP of 120-129/80-84 mm Hg had a 44% increased risk of ESRD.

“Important clinical and public health implications come from these findings,” the authors wrote. For example, they noted that “considering the robust evidence of an association between prehypertension and long-term risk of ESRD shown in our study, consideration of early interventions for prehypertension is preferable to prevent the progression of CKD in the general population.”

In the general population, lifestyle modification is now the mainstay of treatment for prehypertension, the researchers pointed out. High-risk subpopulations with prehypertension, however, especially high-range prehypertension, may be an important study population for future controlled trials of pharmacologic treatment, they stated.

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