Dataset Information

Association of Adolescent Hypertension With Future End-stage Renal Disease.

ABSTRACT:

Importance

Hypertension is a leading risk factor of cardiovascular morbidity and mortality. The role of nonmalignant hypertension as the sole initiating factor of end-stage renal disease (ESRD) in non-African American populations has recently been questioned.

Objective

To investigate the association between hypertension and future ESRD in otherwise healthy adolescents.

Design, setting, and participants

This retrospective cohort study examined the data of 16- to 19-year-old healthy candidates for military service in the Israel Defense Forces between January 1, 1967, and December 31, 2013. Data were obtained from the central conscription registry of the Israel Defense Forces and the ESRD registry of the Israel Ministry of Health. Participants underwent a comprehensive medical assessment prior to their military service. Individuals with evidence of renal damage or kidney-related risk factors were excluded. The data analysis was conducted from February 12, 2017, to October 16, 2018.

Main outcomes and measures

End-stage renal disease as recorded by the Israeli ESRD registry, including hemodialysis, peritoneal dialysis, renal transplant diagnosed between January 1, 1990, and December 31, 2014.

Results

The cohort included 2?658?238 adolescents (1 596 709 [60.1%] male with a mean [SD] age of 17.4 [0.5] years), of whom 7997 (0.3%) had an established hypertension diagnosis. Half of the individuals in the hypertensive group were overweight (1559 [20.1%]) or obese (2243 [28.9%]), and most (7235 [90.5%]) were male. During a median follow-up of 19.6 years (52?287?945 person-years), 2189 individuals developed ESRD, with an incidence rate of 3.9 per 100?000 person-years. Adolescent hypertension was found to be associated with future ESRD (crude hazard ratio [HR], 5.07; 95% CI, 3.73-6.88). In a multivariable model adjusted for sex, age, years of education, body mass index, and other sociodemographic variables, the HR was 1.98 (95% CI, 1.42-2.77). When excluding participants with severe hypertension, the association with ESRD remained statistically significant (HR, 1.93; 95% CI, 1.37-2.70). In the subanalysis of nonoverweight adolescents, the association between hypertension and ESRD was statistically significant as well (HR, 2.11; 95% CI, 1.05-4.24).

Conclusions and relevance

Hypertension appears to be associated with a doubling of the risk of future ESRD in an otherwise healthy adolescent population.

SUBMITTER: Leiba A

PROVIDER: S-EPMC6450304 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Association of Adolescent Hypertension With Future End-stage Renal Disease.

Leiba Adi A Fishman Boris B Twig Gilad G Gilad David D Derazne Estela E Shamiss Ari A Shohat Tamar T Ron Ofir O Grossman Ehud E

JAMA internal medicine 20190401 4

<h4>Importance</h4>Hypertension is a leading risk factor of cardiovascular morbidity and mortality. The role of nonmalignant hypertension as the sole initiating factor of end-stage renal disease (ESRD) in non-African American populations has recently been questioned.<h4>Objective</h4>To investigate the association between hypertension and future ESRD in otherwise healthy adolescents.<h4>Design, setting, and participants</h4>This retrospective cohort study examined the data of 16- to 19-year-old ...[more]

PMID: 30801616

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Dataset Information

Association of Adolescent Hypertension With Future End-stage Renal Disease.

Importance

Objective

Design, setting, and participants

Main outcomes and measures

Results

Conclusions and relevance

Publications

Association of Adolescent Hypertension With Future End-stage Renal Disease.

Similar Datasets

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