1.Prevalence, Predictive Factor, and Clinical Significance of White-Coat Hypertension and Masked Hypertension in Korean Hypertensive patients.
Eui Seock HWANG ; Kee Joon CHOI ; Duk Hyun KANG ; Gi Byoung NAM ; Jae Sik JANG ; Young Hoon JEONG ; Chang Hoon LEE ; Ji Young LEE ; Hyun Koo PARK ; Chong Hun PARK
The Korean Journal of Internal Medicine 2007;22(4):256-262
BACKGROUND: The prevalence and clinical significance of white-coat hypertension (WCHT) and masked hypertension (MHT) are unknown in Koreans. Here we measure the frequency of WCHT and MHT in hypertensive subjects and identify the epidemiologic and/or clinical factors that predict it in Korean subjects. METHDOS: This study is a retrospective analysis of a random sample from February 2004 to October 2005. All patients had measurements of blood pressure (BP) in the clinic and 24-hour ambulatory blood pressure monitoring (ABPM). Subjects were classified into four groups on the basis of daytime ambulatory BP and clinic BP level: 1) Normotension (NT), 2) MHT, 3) WCHT, and 4) sustained hypertension (SHT). RESULTS: For all 967 patients, the mean clinic BP was 157.7+/-22.0/ 95.3+/-13.1 mmHg, and the mean daytime ambulatory BP was 136.4+/-15.0/ 86.2+/-10.7 mmHg. The NT, MHT, WCHT, and SHT groups consisted of 51 (5.3%), 55 (5.7%), 273 (28.2%), and 588 (60.8%) subjects, respectively. The left ventricular mass index was significantly higher in SHT than in the other groups, and was positively correlated with BP, especially ABPM. Compared with NT, the factors associated with MHT were younger age, male gender, higher BMI, clinic BP > or =130 mmHg, and alcohol consumption. Compared with SHT, the factors associated with WCHT were female gender, lower BMI, and clinic BP < 150 mmHg. CONCLUSIONS: WCHT and MHT were prevalent in the hypertensive population. ABPM was more predictive of target organ damage than clinic BP, and could be useful in identifying subjects at risk for WCHT and MHT.
Blood Pressure Monitoring, Ambulatory
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Female
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Health Status Indicators
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Heart Ventricles/*physiopathology/ultrasonography
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Humans
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Hypertension/*epidemiology/ultrasonography
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Hypertrophy, Left Ventricular/*physiopathology/ultrasonography
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Korea/epidemiology
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Male
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Middle Aged
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Prevalence
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Retrospective Studies
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Risk Factors
2.Hypertension and subclinical carotid atherosclerosis in a general population of a rural areas in China.
Min LÜ ; Lu-jiang SHI ; Ping SHI ; Sheng KANG ; Liu-xin WU ; Yang-feng WU
Chinese Journal of Epidemiology 2004;25(10):841-844
OBJECTIVETo explore the association of hypertension and carotid atherosclerosis in a general population in China.
METHODSA population-based epidemiological survey on cardiovascular diseases was performed in autumn, 2002. A total of 1198 rural residents with 426 men and 776 women aged 43 - 73 years, underwent carotid duplex examination. Hypertension was classified into 6 groups of optimal, normal, high-normal, stage 1, 2 and 3.
RESULTS(1) A significant positive dose-response relation was found between hypertension categories, duration of hypertension and intima-media thickness (IMT) in both genders (trend test P < 0.01). After adjustment of age, body mass index, total cholesterol, high density lipoprotein cholesterol, glucose and smoking, the relation did not change. The associations between duration of hypertension and IMT disappeared after further adjustment with blood pressure. (2) The occurrence of plaque was positively associated with blood pressure groups and duration of hypertension, as well as in the age-adjusted models. The associations between duration of hypertension and plaque weakened or disappeared after further adjustment with systolic blood pressure, diastolic blood pressure or hypertension categories.
CONCLUSIONHypertension was associated with subclinical carotid atherosclerosis. Prolonged course of disease might aggravate the carotid atherosclerosis.
Adult ; Aged ; Arteriosclerosis ; complications ; diagnostic imaging ; epidemiology ; Carotid Stenosis ; diagnostic imaging ; epidemiology ; etiology ; China ; epidemiology ; Cross-Sectional Studies ; Female ; Follow-Up Studies ; Humans ; Hypertension ; classification ; complications ; epidemiology ; Male ; Middle Aged ; Prevalence ; Risk Factors ; Rural Health ; Ultrasonography
3.Common Carotid Intima-media Thickness in Patients with Non-alcoholic Fatty Liver Disease: A Population-based Case-control Study.
Kamran B LANKARANI ; Mojtaba MAHMOODI ; Mehrzad LOTFI ; Nima ZAMIRI ; Sayed Taghi HEYDARI ; Fariborz GHAFFARPASAND ; Mohammad Kazem FALLAHZADEH ; Meisam BABAEINEJAD ; Najmeh MAHARLOUEI ; Omid MIRZAEE ; Bita GERAMIZADEH ; Payam PEYMANI
The Korean Journal of Gastroenterology 2013;62(6):344-351
BACKGROUND/AIMS: Metabolic syndrome is a well-known risk factor for atherosclerosis. Non-alcoholic fatty liver disease (NAFLD) has features of metabolic syndromes. This study aimed to investigate the association between NAFLD and atherosclerosis. METHODS: In a population-based study in southern Iran, asymptomatic adult inhabitants aged more than 20 years were selected through cluster random sampling, and were screened for the presence of fatty liver and common carotid intima-media thickness (CIMT), with abdominal and cervical ultrasonography, respectively. Those with fatty liver were compared to the same number of individuals without fatty liver. RESULTS: Two hundred and ninety individuals were found to have fatty change on abdominal ultrasonography, and were labeled NAFLD. Compared to normal individuals, NAFLD patients had significantly higher prevalence of increased CIMT (OR, 1.66; p<0.001). Those with hypertension (HTN), diabetes mellitus (DM), higher waist circumference (WC) and older ages had significantly higher prevalence of thick CIMT. Through adjusting the effects of different variables, we indicated that NAFLD could be an independent risk factor for thick common carotid intima-media (OR, 1.90; 95% CI, 1.17-3.09; p=0.009). It was also shown that age could be another independent risk factor for thick CIMT. CONCLUSIONS: Individuals with risk factors such as HTN, DM, and high WC are prone to develop atherosclerosis of the carotid artery. The presence of NAFLD should be considered as another probable independent factor contributing to the development of carotid atherosclerosis.
Abdomen/ultrasonography
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Adult
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Age Factors
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Aged
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Carotid Arteries/ultrasonography
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*Carotid Intima-Media Thickness
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Case-Control Studies
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Diabetes Complications
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Fatty Liver/epidemiology/*ultrasonography
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Female
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Humans
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Hypertension/complications
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Male
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Middle Aged
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Odds Ratio
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Risk Factors
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Waist Circumference
4.Visceral Obesity If Associated with Gallbladder Polyps.
Jun Kyu LEE ; Suk Jae HAHN ; Hyoun Woo KANG ; Jae Gu JUNG ; Han Seok CHOI ; Jin Ho LEE ; In Woong HAN ; Jin Hee JUNG ; Jae Hyun KWON
Gut and Liver 2016;10(1):133-139
BACKGROUND/AIMS: Gallbladder polyps (GBP) are a common clinical finding and may possess malignant potential. We conducted this study to determine whether visceral obesity is a risk factor for GBP. METHODS: We retrospectively reviewed records of subjects who received both ultrasonography and computed tomography with measurements of the areas of visceral adipose tissue and total adipose tissue (TAT) on the same day as health checkups. RESULTS: Ninety-three of 1,615 subjects (5.8%) had GBP and were compared with 186 age- and sex-matched controls. VAT (odds ratio [OR], 2.941; 95% confidence interval [CI], 1.325 to 6.529; p=0.008 for the highest quartile vs the lowest quartile) and TAT (OR, 3.568; 95% CI, 1.625 to 7.833; p=0.002 for the highest quartile vs the lowest quartile) were independent risk factors together with hypertension (OR, 2.512; 95% CI, 1.381 to 4.569; p=0.003), diabetes mellitus (OR, 2.942; 95% CI, 1.061 to 8.158; p=0.038), hepatitis B virus positivity (OR, 3.548; 95% CI, 1.295 to 9.716; p=0.014), and a higher level of total cholesterol (OR, 2.232; 95% CI, 1.043 to 4.778; p=0.039 for <200 mg/dL vs > or =240 mg/dL). Body mass index and waist circumference were not meaningful variables. CONCLUSIONS: Visceral obesity measured by VAT and TAT was associated with GBP irrespective of body mass index or waist circumference.
Adipose Tissue/ultrasonography
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Adult
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Case-Control Studies
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Cholesterol/blood
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Diabetes Complications
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Female
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Gallbladder Diseases/blood/epidemiology/*etiology
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Hepatitis B/complications
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Humans
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Hypertension/complications
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Intra-Abdominal Fat/ultrasonography
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Male
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Middle Aged
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Obesity, Abdominal/blood/*complications/ultrasonography
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Odds Ratio
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Polyps/blood/epidemiology/*etiology
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Prevalence
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Retrospective Studies
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Risk Factors
5.Reference Diameters of the Abdominal Aorta and Iliac Arteries in the Korean Population.
Jin Hyun JOH ; Hyung Joon AHN ; Ho Chul PARK
Yonsei Medical Journal 2013;54(1):48-54
PURPOSE: It is important to know the normal diameter of artery throughout the body so that clinicians are able to determine when an artery becomes aneurysmal. However, there are no previous studies on the normal diameter of arteries in the general Korean population. The purpose of this article is to determine the normal reference diameters of the abdominal aorta and iliac arteries in the Korean population. MATERIALS AND METHODS: We recruited the study population from three cities in Korea for the abdominal aortic aneurysm (AAA) screening. We measured the diameter of the aorta and iliac arteries. We analyzed the reference diameter of the population without AAA. The results were analyzed by Student's t-test and ANOVA on SPSS version 19. A p value <0.05 was considered to be statistically significant. RESULTS: One thousand two hundred and twenty-nine people were enrolled. 478 men and 751 women, with a mean age of 63.9+/-10.1 years (range 50 to 91) were examined. Eleven out of 1229 (0.89%) were diagnosed with AAA. In the population of 1218 people without AAA, the mean diameters (cm) of male/female were 2.20/2.11 (p<0.001) at suprarenal, 2.04/1.90 (p<0.001) at renal, 1.90/1.79 (p<0.001) at infrarenal, 1.22/1.17 (p<0.001) at right iliac and 1.47/1.15 (p=0.097) at the left iliac, respectively. There was a significantly larger diameter in the male population. The diameter of each level increased with age. CONCLUSION: The normal reference diameter of the infrarenal abdominal aorta in the Korean population is 1.9 cm in males and 1.79 cm in females. The diameter of the abdominal aorta increases with age.
Age Factors
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Aged
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Aged, 80 and over
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Aorta, Abdominal/*anatomy & histology/ultrasonography
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Aortic Aneurysm, Abdominal/diagnosis/epidemiology
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Female
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Humans
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Hypertension/complications
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Iliac Artery/*anatomy & histology
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Male
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Middle Aged
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Reference Values
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Republic of Korea
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Risk Factors
6.Elevated red cell distribution width is associated with advanced fibrosis in NAFLD.
Hwa Mok KIM ; Bum Soo KIM ; Yong Kyun CHO ; Byung Ik KIM ; Chong Il SOHN ; Woo Kyu JEON ; Hong Joo KIM ; Dong Il PARK ; Jung Ho PARK ; Kwan Joong JOO ; Chang Joon KIM ; Yong Sung KIM ; Woon Je HEO ; Won Seok CHOI
Clinical and Molecular Hepatology 2013;19(3):258-265
BACKGROUND/AIMS: The red-blood-cell distribution width (RDW) is a newly recognized risk marker in patients with cardiovascular disease, but its role in nonalcoholic fatty liver disease (NAFLD) has not been well defined. The aim of the present study was to determine the association between RDW values and the level of fibrosis in NAFLD according to BARD and FIB-4 scores. METHODS: This study included 24,547 subjects who had been diagnosed with NAFLD based on abdominal ultrasonography and questionnaires about alcohol consumption. The degree of liver fibrosis was determined according to BARD and FIB-4 scores. The association between RDW values and the degree of fibrosis in NAFLD was analyzed retrospectively. RESULTS: After adjusting for age, hemoglobin level, mean corpuscular volume, history of hypertension, history of diabetes, and high-sensitivity C-reactive protein, the RDW values were 12.61+/-0.41% (mean+/-SD), 12.70+/-0.70%, 12.77+/-0.62%, 12.87+/-0.82%, and 13.25+/-0.90% for those with BARD scores of 0, 1, 2, 3, and 4, respectively, and 12.71+/-0.72%, 12.79+/-0.66%, and 13.23+/-1.52% for those with FIB-4 scores of <1.30, 1.31-2.66, and > or =2.67, respectively (P<0.05). The prevalence of advanced fibrosis (BARD score of 24 and FIB-4 score of > or =1.3) increased with the RDW [BARD score: 51.1% in quartile 1 (Q1) vs. 63.6% in Q4; FIB-4 score: 6.9% in Q1 vs. 10.5% in Q4; P<0.001]. After adjustments, the odds ratio of having advanced fibrosis for those in Q4 compared to Q1 were 1.76 (95%CI=1.55-2.00, P<0.001) relative to BARD score and 1.69 (95%CI=1.52-1.98, P<0.001) relative to FIB-4 score. CONCLUSIONS: Elevated RDW is independently associated with advanced fibrosis in NAFLD.
Adult
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Alcohol Drinking
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C-Reactive Protein/analysis
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Diabetes Mellitus/pathology
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Erythrocyte Indices
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Fatty Liver/complications/*diagnosis/ultrasonography
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Female
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Humans
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Hypertension/pathology
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Liver Cirrhosis/*diagnosis/epidemiology/etiology
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Male
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Middle Aged
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Odds Ratio
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Prevalence
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Questionnaires
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Severity of Illness Index
7.Prevalence of Asymptomatic Carotid Stenosis in Korea Based on Health Screening Population.
Young Nam ROH ; Shin Young WOO ; Nari KIM ; Seonwoo KIM ; Young Wook KIM ; Dong Ik KIM
Journal of Korean Medical Science 2011;26(9):1173-1177
We attempted to investigate the prevalence and risk factors of carotid artery stenosis in Korea. Twenty thousand seven hundred twelve individuals who underwent carotid artery ultrasonography for health screening between March 2005 and March 2010 were retrospectively evaluated. The population was divided into four groups, according to the degree of stenosis, as Group A, below 29%; Group B, 30% to 49%; Group C, 50% to 74%; Group D, above 75%. The medical records of the individuals were investigated, and Fisher's exact test, chi-square tests, Kruskal-Wallis tests and a binary logistic regression model were used for statistical analysis. The prevalence of carotid stenosis was Group B, 5.5%; Group C, 0.9%; Group D, 0.1%. Old age, male gender, hypertension, diabetes mellitus and ischemic heart disease were significantly higher in Groups C and D (P = 0.001, 0.001, 0.001, 0.048, and 0.001, respectively). Among the males aged over 65 yr, the prevalence of carotid stenosis > or = 50% and > or = 30% were 4.0% and 18.2%, respectively. Asymptomatic carotid stenosis is not uncommon in Korea. Carotid ultrasonography is necessary for people with above-listed risk factors.
Adolescent
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Adult
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Age Factors
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Aged
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Aged, 80 and over
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Carotid Stenosis/complications/*epidemiology/ultrasonography
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Data Interpretation, Statistical
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Diabetes Mellitus, Type 2/complications
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Female
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Health Surveys
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Humans
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Hypertension/complications
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Male
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Middle Aged
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Myocardial Ischemia/complications
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Prevalence
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Republic of Korea/epidemiology
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Retrospective Studies
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Risk Factors
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Sex Factors
8.Non-Dipper Status and Left Ventricular Hypertrophy as Predictors of Incident Chronic Kidney Disease.
Hye Rim AN ; Sungha PARK ; Tae Hyun YOO ; Shin Wook KANG ; Jung Hwa RYU ; Yong Kyu LEE ; Mina YU ; Dong Ryeol RYU ; Seung Jung KIM ; Duk Hee KANG ; Kyu Bok CHOI
Journal of Korean Medical Science 2011;26(9):1185-1190
We have hypothesized that non-dipper status and left ventricular hypertrophy (LVH) are associated with the development of chronic kidney disease (CKD) in non-diabetic hypertensive patients. This study included 102 patients with an estimated glomerular filtration rate (eGFR) > or = 60 mL/min/1.73 m2. Ambulatory blood pressure monitoring and echocardiography were performed at the beginning of the study, and the serum creatinine levels were followed. During the average follow-up period of 51 months, CKD developed in 11 patients. There was a significant difference in the incidence of CKD between dippers and non-dippers (5.0% vs 19.0%, P < 0.05). Compared to patients without CKD, patients with incident CKD had a higher urine albumin/creatinine ratio (52.3 +/- 58.6 mg/g vs 17.8 +/- 29.3 mg/g, P < 0.01), non-dipper status (72.7% vs 37.4%, P < 0.05), the presence of LVH (27.3% vs 5.5%, P < 0.05), and a lower serum HDL-cholesterol level (41.7 +/- 8.3 mg/dL vs 50.4 +/- 12.4 mg/dL, P < 0.05). Based on multivariate Cox regression analysis, non-dipper status and the presence of LVH were independent predictors of incident CKD. These findings suggest that non-dipper status and LVH may be the therapeutic targets for preventing the development of CKD in non-diabetic hypertensive patients.
Adult
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Aged
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Aged, 80 and over
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Albumins/analysis
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Blood Pressure
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Blood Pressure Monitoring, Ambulatory
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Cholesterol, HDL/blood
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Chronic Disease
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Creatinine/blood/urine
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Cross-Sectional Studies
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Female
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Follow-Up Studies
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Glomerular Filtration Rate
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Humans
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Hypertension/complications
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Hypertrophy, Left Ventricular/complications/*diagnosis
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Incidence
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Kidney Diseases/epidemiology/*etiology/ultrasonography
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Male
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Middle Aged
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*Predictive Value of Tests
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Retrospective Studies