Kidney Week

Abstract: FR-PO376

Incident Hypertension in Young Adults with a Modest eGFR Reduction

Session Information

• Hypertension, CVD, and the Kidneys: Epidemiology
  October 25, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Hypertension and CVD

• 1602 Hypertension and CVD: Clinical

Authors

• Ahmed, Sumaiya, Ottawa Hospital, Ottawa, Ontario, Canada

Sumaiya Ahmed, MD

• Hussain, Junayd, Ottawa Hospital, Ottawa, Ontario, Canada

Junayd Hussain, MSc

• Akbari, Ayub, Ottawa Hospital, Ottawa, Ontario, Canada

Ayub Akbari, MD, MS, MSc, FASN

• Ravani, Pietro, Alberta Health Services, Edmonton, Alberta, Canada

Pietro Ravani, MD, PhD

• Hundemer, Gregory L., Ottawa Hospital, Ottawa, Ontario, Canada

Gregory L. Hundemer, MD, MPH

• Ramsay, Tim, Ottawa Hospital, Ottawa, Ontario, Canada

Tim Ramsay, PhD

• Bugeja, Ann, Ottawa Hospital, Ottawa, Ontario, Canada

Ann Bugeja, MD

• Knoll, Greg A., Ottawa Hospital, Ottawa, Ontario, Canada

Greg A. Knoll, MD

• Sood, Manish M., Ottawa Hospital, Ottawa, Ontario, Canada

Manish M. Sood, MD, MS, FASN

Background

Hypertension (HTN) is a common, modifiable risk factors for cardiovascular (CV) disease with a rising occurrence in young adults (18-39). Advanced chronic kidney disease is well established as a risk factor for HTN, however, uncertainty remains regarding the relationship between modest eGFR declines (between 60 to 100 ml/min) and HTN.

Methods

A retrospective cohort study of 8.7 million individuals (3.6 million aged 18-39 years) using linked provincial healthcare datasets from Ontario, Canada from January 2008 to March 2021. Cox models were conducted to examine the association of categorized eGFR (50-120 mL/min/1.73m²) and incident HTN, stratified by age (18-39, 40-49, 50-65 years).

Results

Among our cohort (8.7 million individuals, mean age 41.3, mean eGFR 104.2, median follow-up 9.2 years), a step wise increase in blood pressure was observed elevations in blood pressure observed as early as eGFR<90 in young adults (eg. at eGFR 70-80, ages 18-30: 10.5 events per 1000 person-years(p-y), HR 1.31 (1.27-1.40); ages 40-49: 20.4/1000p-y, HR 1.07 (1.05-1.09); ages 50-65: 31.9/1000p-y, HR 1.03 (1.02-1.04) (figure 1). In addition, HTN was detected in patients with mild to negligeable albuminuria with increasing incidence as GFR declined. Among young adults who developed HTN, CV events were higher, and this increased with modest eGFR reductions.

Conclusion

HTN in young adults is associated with modest reductions in eGFR (<70-80) and a higher risk of CV consequences warranting early identification, monitoring, and management.