OBJECTIVES: Chronic kidney disease (CKD) is a prevalent health issue that causes the irreversible loss of functioning nephrons, end-stage renal disease, cardiovascular disease, and premature mortality. Hypertension is the leading cause of CKD. However, the effect of long-term blood pressure (BP) changes on the development of CKD is still unknown. Therefore, the current study investigated the association between BP trajectory and the future development of CKD. METHODS: In this study, 246,874 individuals aged ≥40 years who underwent health examinations during the screening period (2002-2009) were evaluated. The systolic blood pressure (SBP) trajectory was determined using latent-class mixture modeling. New-onset CKD was identified during the follow-up period (2010-2019). The association between SBP trajectories and new-onset CKD was assessed. RESULTS: In total, 111,900 adults (53,420 females, 51.9±6.4 years old) presented with 2 SBP trajectory classes: class 1 (n=66,935) and class 2 (n=44,965). During the follow-up period, patients with SBP trajectory class 2 had an approximately 2.1-fold increased risk of developing CKD (unadjusted hazard ratio [HR], 2.11; 95% confidence interval [CI], 1.99 to 2.25; p<0.001). In the multivariate analysis adjusted for other significant variables, SBP trajectory class 2 was significantly associated with CKD in males (HR, 1.09; 95% CI, 1.00 to 1.19; p=0.037), but not in females (HR, 1.06; 95% CI, 0.95 to 1.18; p=0.321). CONCLUSIONS An elevated longitudinal BP was associated with a higher incidence of CKD in male participants aged ≥40 years. Nevertheless, further studies are needed to validate the clinical significance of an elevated SBP trajectory on CKD development.

OBJECTIVES: Chronic kidney disease (CKD) is a prevalent health issue that causes the irreversible loss of functioning nephrons, end-stage renal disease, cardiovascular disease, and premature mortality. Hypertension is the leading cause of CKD. However, the effect of long-term blood pressure (BP) changes on the development of CKD is still unknown. Therefore, the current study investigated the association between BP trajectory and the future development of CKD. METHODS: In this study, 246,874 individuals aged ≥40 years who underwent health examinations during the screening period (2002-2009) were evaluated. The systolic blood pressure (SBP) trajectory was determined using latent-class mixture modeling. New-onset CKD was identified during the follow-up period (2010-2019). The association between SBP trajectories and new-onset CKD was assessed. RESULTS: In total, 111,900 adults (53,420 females, 51.9±6.4 years old) presented with 2 SBP trajectory classes: class 1 (n=66,935) and class 2 (n=44,965). During the follow-up period, patients with SBP trajectory class 2 had an approximately 2.1-fold increased risk of developing CKD (unadjusted hazard ratio [HR], 2.11; 95% confidence interval [CI], 1.99 to 2.25; p<0.001). In the multivariate analysis adjusted for other significant variables, SBP trajectory class 2 was significantly associated with CKD in males (HR, 1.09; 95% CI, 1.00 to 1.19; p=0.037), but not in females (HR, 1.06; 95% CI, 0.95 to 1.18; p=0.321). CONCLUSIONS An elevated longitudinal BP was associated with a higher incidence of CKD in male participants aged ≥40 years. Nevertheless, further studies are needed to validate the clinical significance of an elevated SBP trajectory on CKD development.

OBJECTIVES: Chronic kidney disease (CKD) is a prevalent health issue that causes the irreversible loss of functioning nephrons, end-stage renal disease, cardiovascular disease, and premature mortality. Hypertension is the leading cause of CKD. However, the effect of long-term blood pressure (BP) changes on the development of CKD is still unknown. Therefore, the current study investigated the association between BP trajectory and the future development of CKD. METHODS: In this study, 246,874 individuals aged ≥40 years who underwent health examinations during the screening period (2002-2009) were evaluated. The systolic blood pressure (SBP) trajectory was determined using latent-class mixture modeling. New-onset CKD was identified during the follow-up period (2010-2019). The association between SBP trajectories and new-onset CKD was assessed. RESULTS: In total, 111,900 adults (53,420 females, 51.9±6.4 years old) presented with 2 SBP trajectory classes: class 1 (n=66,935) and class 2 (n=44,965). During the follow-up period, patients with SBP trajectory class 2 had an approximately 2.1-fold increased risk of developing CKD (unadjusted hazard ratio [HR], 2.11; 95% confidence interval [CI], 1.99 to 2.25; p<0.001). In the multivariate analysis adjusted for other significant variables, SBP trajectory class 2 was significantly associated with CKD in males (HR, 1.09; 95% CI, 1.00 to 1.19; p=0.037), but not in females (HR, 1.06; 95% CI, 0.95 to 1.18; p=0.321). CONCLUSIONS An elevated longitudinal BP was associated with a higher incidence of CKD in male participants aged ≥40 years. Nevertheless, further studies are needed to validate the clinical significance of an elevated SBP trajectory on CKD development.

OBJECTIVES: Chronic kidney disease (CKD) is a prevalent health issue that causes the irreversible loss of functioning nephrons, end-stage renal disease, cardiovascular disease, and premature mortality. Hypertension is the leading cause of CKD. However, the effect of long-term blood pressure (BP) changes on the development of CKD is still unknown. Therefore, the current study investigated the association between BP trajectory and the future development of CKD. METHODS: In this study, 246,874 individuals aged ≥40 years who underwent health examinations during the screening period (2002-2009) were evaluated. The systolic blood pressure (SBP) trajectory was determined using latent-class mixture modeling. New-onset CKD was identified during the follow-up period (2010-2019). The association between SBP trajectories and new-onset CKD was assessed. RESULTS: In total, 111,900 adults (53,420 females, 51.9±6.4 years old) presented with 2 SBP trajectory classes: class 1 (n=66,935) and class 2 (n=44,965). During the follow-up period, patients with SBP trajectory class 2 had an approximately 2.1-fold increased risk of developing CKD (unadjusted hazard ratio [HR], 2.11; 95% confidence interval [CI], 1.99 to 2.25; p<0.001). In the multivariate analysis adjusted for other significant variables, SBP trajectory class 2 was significantly associated with CKD in males (HR, 1.09; 95% CI, 1.00 to 1.19; p=0.037), but not in females (HR, 1.06; 95% CI, 0.95 to 1.18; p=0.321). CONCLUSIONS An elevated longitudinal BP was associated with a higher incidence of CKD in male participants aged ≥40 years. Nevertheless, further studies are needed to validate the clinical significance of an elevated SBP trajectory on CKD development.

Background: Although the presence of both obesity and reduced muscle mass presents a dual metabolic burden and additively has a negative effect on a variety of cardiometabolic parameters, data regarding the associations between their combined effects and left ventricular diastolic function are limited. This study investigated the association between the ratio of skeletal muscle mass to visceral fat area (SVR) and left ventricular diastolic dysfunction (LVDD) in patients with preserved ejection fraction using random forest machine learning. Methods: In total, 1,070 participants with preserved left ventricular ejection fraction who underwent comprehensive health examinations, including transthoracic echocardiography and bioimpedance body composition analysis, were enrolled. SVR was calculated as an index of sarcopenic obesity by dividing the appendicular skeletal muscle mass by the visceral fat area. Results: In the random forest model, age and SVR were the most powerful predictors of LVDD. Multivariate logistic regression analysis demonstrated that older age (adjusted odds ratio [OR], 1.11; 95% confidence interval [CI], 1.07 to 1.15) and lower SVR (adjusted OR, 0.08; 95% CI, 0.01 to 0.57) were independent risk factors for LVDD.SVR showed a significant improvement in predictive performance and fair predictability for LVDD, with the highest area under the curve noted in both men and women, with statistical significance. In non-obese and metabolically healthy individuals, the lowest SVR tertile was associated with a greater risk of LVDD compared to the highest SVR tertile. Conclusion Decreased muscle mass and increased visceral fat were significantly associated with LVDD compared to obesity, body fat composition, and body muscle composition indices.

Background: Although the presence of both obesity and reduced muscle mass presents a dual metabolic burden and additively has a negative effect on a variety of cardiometabolic parameters, data regarding the associations between their combined effects and left ventricular diastolic function are limited. This study investigated the association between the ratio of skeletal muscle mass to visceral fat area (SVR) and left ventricular diastolic dysfunction (LVDD) in patients with preserved ejection fraction using random forest machine learning. Methods: In total, 1,070 participants with preserved left ventricular ejection fraction who underwent comprehensive health examinations, including transthoracic echocardiography and bioimpedance body composition analysis, were enrolled. SVR was calculated as an index of sarcopenic obesity by dividing the appendicular skeletal muscle mass by the visceral fat area. Results: In the random forest model, age and SVR were the most powerful predictors of LVDD. Multivariate logistic regression analysis demonstrated that older age (adjusted odds ratio [OR], 1.11; 95% confidence interval [CI], 1.07 to 1.15) and lower SVR (adjusted OR, 0.08; 95% CI, 0.01 to 0.57) were independent risk factors for LVDD.SVR showed a significant improvement in predictive performance and fair predictability for LVDD, with the highest area under the curve noted in both men and women, with statistical significance. In non-obese and metabolically healthy individuals, the lowest SVR tertile was associated with a greater risk of LVDD compared to the highest SVR tertile. Conclusion Decreased muscle mass and increased visceral fat were significantly associated with LVDD compared to obesity, body fat composition, and body muscle composition indices.

Background: Although the presence of both obesity and reduced muscle mass presents a dual metabolic burden and additively has a negative effect on a variety of cardiometabolic parameters, data regarding the associations between their combined effects and left ventricular diastolic function are limited. This study investigated the association between the ratio of skeletal muscle mass to visceral fat area (SVR) and left ventricular diastolic dysfunction (LVDD) in patients with preserved ejection fraction using random forest machine learning. Methods: In total, 1,070 participants with preserved left ventricular ejection fraction who underwent comprehensive health examinations, including transthoracic echocardiography and bioimpedance body composition analysis, were enrolled. SVR was calculated as an index of sarcopenic obesity by dividing the appendicular skeletal muscle mass by the visceral fat area. Results: In the random forest model, age and SVR were the most powerful predictors of LVDD. Multivariate logistic regression analysis demonstrated that older age (adjusted odds ratio [OR], 1.11; 95% confidence interval [CI], 1.07 to 1.15) and lower SVR (adjusted OR, 0.08; 95% CI, 0.01 to 0.57) were independent risk factors for LVDD.SVR showed a significant improvement in predictive performance and fair predictability for LVDD, with the highest area under the curve noted in both men and women, with statistical significance. In non-obese and metabolically healthy individuals, the lowest SVR tertile was associated with a greater risk of LVDD compared to the highest SVR tertile. Conclusion Decreased muscle mass and increased visceral fat were significantly associated with LVDD compared to obesity, body fat composition, and body muscle composition indices.