Albuminuria in relation to the single and combined effects of systolic and diastolic blood pressure in Chinese.

We investigated the single and combined effects of systolic (SBP) and diastolic blood pressure (DBP) on albuminuria in Chinese. We measured blood pressure (BP), anthropometry and urinary excretions of albumin and creatinine, and defined albuminuria as a urinary albumin-to-creatinine ratio of at least 17 and 25 mg/g in men and women, respectively. The 1068 participants (mean age 56.3 years) included 407 (38.5%) men and 410 (38.4%) hypertensive patients. A J-shaped relationship between the risk of albuminuria and BP was observed for both SBP (mean ± SD, 126.1 ± 18.9 mmHg) and DBP (77.1 ± 9.4 mmHg) with nadir levels of 110 mmHg and 70 mmHg, respectively. The risk of albuminuria was significantly (p ≤ 0.01) associated with DBP in the subjects with a SBP of at least 130 mmHg and with SBP in subjects with a DBP of at least 80 mmHg, and inversely and significantly (p = 0.04) associated with SBP in subjects with a DBP below 70 mmHg. In conclusion, as far as albuminuria is concerned, there is indeed a J-shaped phenomenon. However, it has a nadir level far below the currently recommended target BP of 140/90 or 130/80 mmHg.