{
  "abstract": "We investigated the association between blood pressure (BP) and the risk of cardiovascular disease (CVD) in individuals with non-proteinuric chronic kidney disease (CKD) without diabetes. Using a large-scale nationwide administrative claims and health checkup database in Japan, we identified 287,238 non-diabetic adults with an estimated glomerular filtration rate <60 mL/min/1.73 m2 and negative/trace proteinuria. We examined the association between BP and CVD events by modeling BP both as a continuous variable and as a categorical variable according to the 2017 ACC/AHA guideline classification. The primary outcome was a composite of myocardial infarction, stroke, heart failure, and atrial fibrillation. Multivariable Cox regression analyses showed that higher systolic BP (SBP) was associated with increased CVD risk (hazard ratio [HR] 1.05 per 10 mmHg; 95% CI 1.04–1.05). Compared with normal BP, the HRs were 1.03 (95% CI 1.00–1.07) for elevated BP, 1.08 (1.05–1.11) for stage 1 hypertension, and 1.20 (1.17–1.24) for stage 2 hypertension. Restricted cubic spline analysis showed an increase in CVD risk at SBP levels above ~130 mmHg. However, among individuals receiving antihypertensive medication, a U-shaped association was observed, with an increased risk also evident at SBP levels below ~130 mmHg. In individuals with non-proteinuric CKD without diabetes, higher SBP was positively associated with increased cardiovascular risk. However, a U-shaped association observed among individuals receiving antihypertensive treatment suggests that the relationship between BP and cardiovascular risk may be complex in this population, highlighting the potential importance of individualized clinical assessment.",
  "abstract_shown": true,
  "affiliations": [
    "The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan",
    "Center for Outcomes Research and Economic Evaluation for Health, National Institute of Public Health, Saitama, Japan",
    "The Department of Advanced Cardiology, The University of Tokyo, Tokyo, Japan",
    "Department of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan",
    "International University of Health and Welfare, Tokyo, Japan",
    "Division of Cardiology and Nephrology, Department of Internal Medicine, Asahikawa Medical University, Asahikawa, Japan",
    "Division of Nephrology, Endocrinology, and Metabolism, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan",
    "Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan",
    "Department of Cardiovascular Medicine, Saga University, Saga, Japan",
    "The Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 15,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Yuta Suzuki"
    },
    {
      "affs": [
        0
      ],
      "name": "Masachika Nishikawa"
    },
    {
      "affs": [
        0,
        2
      ],
      "name": "Hidehiro Kaneko"
    },
    {
      "affs": [
        3
      ],
      "name": "Akira Okada"
    },
    {
      "affs": [
        0
      ],
      "name": "Toshiyuki Ko"
    },
    {
      "affs": [
        0,
        2
      ],
      "name": "Katsuhito Fujiu"
    },
    {
      "affs": [
        0
      ],
      "name": "Norifumi Takeda"
    },
    {
      "affs": [
        0,
        4
      ],
      "name": "Hiroyuki Morita"
    },
    {
      "affs": [
        5
      ],
      "name": "Naoki Nakagawa"
    },
    {
      "affs": [
        6
      ],
      "name": "Tatsuhiko Azegami"
    },
    {
      "affs": [
        6
      ],
      "name": "Kaori Hayashi"
    },
    {
      "affs": [
        7
      ],
      "name": "Takashi Yokoo"
    },
    {
      "affs": [
        8
      ],
      "name": "Koichi Node"
    },
    {
      "affs": [
        9
      ],
      "name": "Hideo Yasunaga"
    },
    {
      "affs": [
        0
      ],
      "name": "Norihiko Takeda"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/3srfd64jh7c11.bib",
  "cited_by": 1,
  "doi": "10.1038/s41440-026-02801-7",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13736525/",
  "id": "3srfd64jh7c11",
  "issns": [
    "0916-9636",
    "1348-4214"
  ],
  "landing_url": "https://doi.org/10.1038/s41440-026-02801-7",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Article"
    ],
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      "openalex",
      "2705|Blood Pressure and Hypertension Studies"
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  "pdf_url": "https://www.nature.com/articles/s41440-026-02801-7.pdf",
  "pmcid": "PMC13736525",
  "pmid": "42722733",
  "published": "2026-09-10",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/3srfd64jh7c11.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T12:21:57Z",
      "native_id": "PMC13736525",
      "source": "pmc",
      "url": "https://doi.org/10.1038/s41440-026-02801-7"
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2705|Blood Pressure and Hypertension Studies",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Blood pressure and cardiovascular risk in adults with non-proteinuric chronic kidney disease without diabetes",
  "title_text": "Blood pressure and cardiovascular risk in adults with non-proteinuric chronic kidney disease without diabetes",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T12:21:57Z",
  "url": "https://research.draconitic.com/paper/3srfd64jh7c11",
  "venue": "Hypertension Research",
  "versions": []
}