Hypertension, Hypertension Control, and Chronic Kidney Disease in a Malay Population in Singapore

Studies conducted in Western populations demonstrate that blood pressure (BP) is a major risk factor for chronic kidney disease (CKD). The authors examined the cross-sectional association between BP and CKD in 3280 adults of Malay ethnicity aged 40 to 80 years living in Singapore. CKD was defined as ( I) estimated glomerular filtration rate (eGFR) of < 60 mL/min/1.73 m(2) and (2) presence of microalbuminuria/macroalbuminuria. They observed a dose-dependent positive association between BP and CKD (P trend < .0001). In multivariable-adjusted analysis, compared with participants with normal BP, the odds ratio (OR; 95% confidence interval [CI]) of eGFR < 60 mL/min/1.73 m(2) was 1.85 (0.95-3.62), 2.95 (1.55-5.64), and 4.96 (2.63-9.37) for prehypertension, and stage I and stage 2 hypertension, respectively. Similar results were obtained for microalbuminuria/macroalbuminuria. Stage 2 hypertension had the greatest population-attributable risk of CKD (23%). The strong positive association of hypertension with CKD emphasizes the need to control BP in Asian populations to reduce the burden of kidney disease.