Association between Age of Onset of Hypertension and Risk of CKD

Key Points This study definitively explores the effect of age at onset of hypertension on the subsequent incidence of CKD. Our study also illuminates subgroup differences within populations characterized by different ages at onset of hypertension. Background The onset age of hypertension (HTN) has decreased significantly because of lifestyle changes over the years. However, the link between HTN onset age and subsequent incidence of CKD remains unclear. Methods Individual-level data were obtained from the UK Biobank. Information on the diagnosis of HTN and CKD was collected at baseline and follow-up. The propensity score matching method and Cox proportional hazards models were used to evaluate the relationship between different HTN morbidity ages and the incidence of CKD. Results A total of 485,101 participants without CKD at baseline were included in this analysis (women, 265,343 [54.70%]). Among the 186,880 participants with HTN, the multivariable-adjusted hazard ratio for developing CKD was 1.117 (95% confidence interval, 1.102 to 1.132) for each 10-year decrease in age at the onset of HTN. After applying propensity score matching, the risk of CKD in hypertensive patients was significantly higher compared with those without HTN across all age groups. In addition, the hazard ratios tended to increase with a decrease in age at the onset of HTN. Subgroup analysis showed that participants with cardiovascular disease at baseline increased the adverse effect of HTN on CKD in younger participants. Conclusions Our research indicated that the younger the age at HTN diagnosis, the greater the risk of developing CKD. Individuals who experience the onset of HTN before the age of 45 years may constitute a high-risk CKD subpopulation, highlighting the need for vigilant monitoring and early intervention.