{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T12:23:00Z","timestamp":1769689380300,"version":"3.49.0"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"23","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,12,3]]},"abstract":"\n Background<\/jats:title>\n \n Although hypertension is an established risk factor for chronic kidney disease, less is known about the relationship of pulse pressure (\n PP<\/jats:styled-content>\n ), a measure of arterial stiffness, with chronic kidney disease. We investigated the association of systolic blood pressure (\n BP<\/jats:styled-content>\n ), diastolic BP,\n PP,<\/jats:styled-content>\n and mean arterial pressure with the risk of end\u2010stage renal disease (\n ESRD<\/jats:styled-content>\n ) in the prospective population\u2010based Singapore Chinese Health Study.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n We used data from 30\u00a0636 participants who had\n BP<\/jats:styled-content>\n measured at ages 46 to 85\u00a0years during follow\u2010up I interviews between 1999 and 2004. Information on lifestyle factors was collected at recruitment from 1993 to 1998, and selected factors were updated at follow\u2010up I. We identified 463\n ESRD<\/jats:styled-content>\n cases over an average 11.3\u00a0years of follow\u2010up I by linkage with the nationwide Singapore Renal Registry. Cox proportional hazards regression models were used to assess the relations between different\n BP<\/jats:styled-content>\n indexes and\n ESRD<\/jats:styled-content>\n risk. Each\n BP<\/jats:styled-content>\n index was positively associated with\n ESRD<\/jats:styled-content>\n when studied individually. However, when\n PP<\/jats:styled-content>\n was included as a covariate,\n systolic<\/jats:styled-content>\n and diastolic BP and mean arterial pressure were no longer associated with\n ESRD<\/jats:styled-content>\n . Conversely,\n PP<\/jats:styled-content>\n remained significantly associated with\n ESRD<\/jats:styled-content>\n risk in a dose\u2010dependent manner (\n P<\/jats:italic>\n trend<\/jats:sub>\n <0.001) after adjusting for\n systolic<\/jats:styled-content>\n or diastolic BP. Compared with the lowest group (<45\u00a0mm\u00a0Hg) of\n PP<\/jats:styled-content>\n , the hazard ratio was 5.25 (95% CI, 3.52\u20137.84) for the highest group (\u226585\u00a0mm\u00a0Hg). The association between hypertension and\n ESRD<\/jats:styled-content>\n risk was attenuated and no longer significant after adjusting for\n PP<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Our findings provide a basis for targeting reduction of arterial stiffness to decrease\n ESRD<\/jats:styled-content>\n risk.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.119.013282","type":"journal-article","created":{"date-parts":[[2019,11,26]],"date-time":"2019-11-26T10:00:24Z","timestamp":1574762424000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":21,"title":["Pulse Pressure and the Risk of End\u2010Stage Renal Disease Among Chinese Adults in Singapore: The Singapore Chinese Health Study"],"prefix":"10.1161","volume":"8","author":[{"given":"Ting\u2010Ting","family":"Geng","sequence":"first","affiliation":[{"name":"Saw Swee Hock School of Public Health National University of Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad","family":"Talaei","sequence":"additional","affiliation":[{"name":"Health Services and Systems Research Duke\u2010NUS Medical School Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tazeen Hasan","family":"Jafar","sequence":"additional","affiliation":[{"name":"Health Services and Systems Research Duke\u2010NUS Medical School Singapore"},{"name":"Department of Renal Medicine Singapore General Hospital Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jian\u2010Min","family":"Yuan","sequence":"additional","affiliation":[{"name":"Division of Cancer Control and Population Sciences University of Pittsburgh Cancer Institute Pittsburgh PA"},{"name":"Department of Epidemiology University of Pittsburgh Graduate School of Public Health Pittsburgh PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Woon\u2010Puay","family":"Koh","sequence":"additional","affiliation":[{"name":"Saw Swee Hock School of Public Health National University of Singapore Singapore"},{"name":"Health Services and Systems Research Duke\u2010NUS Medical School Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2015.230"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-1755.2005.00774.x"},{"key":"e_1_3_2_4_2","unstructured":"United States Renal Data System . 2018 USRDS annual data report: epidemiology of kidney disease in the United States. 2018;2018."},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2015.08.027"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2013.07.024"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0156575"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.ASN.0000031805.09178.37"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/ajh\/hpt067"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1038\/ajh.2012.48"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2006111199"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1001286"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.7326\/M16-2966"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1201\/b13568"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.281.7.634"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.100.4.354"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2012.131"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1093\/ajh\/hpu206"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.03000315"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1207\/S15327914nc392_5"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.118.008911"},{"key":"e_1_3_2_22_2","unstructured":"National Registry of Diseases Office . 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