, 2012), leaving uncertainty regarding

the respective contributions find more of these factors to the development of hypertension. Asians, a racial/ethnic group with a high prevalence of hypertension (Kearney et al., 2005 and Kubo et al., 2008), are particularly understudied regarding this issue. Therefore, the purpose of the present study was to investigate the independent association of the presence of proteinuria and a reduced eGFR with incident hypertension in a prospective cohort study of young to middle-aged Japanese males with annual BP evaluation. The study subjects included Japanese males who underwent annual medical checkups at their workplaces, all of which were blue-chip companies in Japan (Kondo et al., 2013 and Yamashita et al., 2012). Japanese males 16–59 years of

age (n = 33,914) were recruited in 2000. We excluded participants with preexisting hypertension (systolic BP ≥ 140 mm Hg, diastolic BP ≥ 90 mm Hg or the use of antihypertensive drugs; n = 4688 at baseline examination) and excluded participants aged < 18 years old (n = 45), with a final sample of 29,181 participants. Annual medical checkups including blood test and dipstick urine test were conducted through 2010 or until retirement at around 60 years of age. All participants were individually interviewed using a structured questionnaire in the baseline and annual follow-up surveys. The following information was recorded by trained observers: smoking status, alcohol intake, medical first history and medications. The smoking status and alcohol intake were classified as current vs. former/never. Weight and height were measured while the subject was wearing light Quisinostat cell line clothing without shoes. The body mass index (BMI) was computed as the weight in kilograms divided by the square of the height in meters. Urine and blood samples were obtained in the morning with overnight

fasting. A urinalysis for proteinuria was conducted with Uropaper III (Eiken Chemical Co., Ltd., Tokyo, Japan), and the results were measured using a US-2100 Automated Urine Analyzer (trace (±) corresponds to proteinuria ≥ 15 mg/dl, 1 + to ≥ 30 mg/dl, 2 + to ≥ 100 mg/dl, 3 + to ≥ 300 mg/dl and 4 + to ≥ 1000 mg/dl). The blood analyses were conducted at a single laboratory. The GFR was estimated using the three-variable equation proposed by the Japanese Society of Nephrology (eGFR [ml/min/1.73 m2] = 194 × serum creatinine− 1.094 × age− 0.287 × 0.739 [if female]) (Matsuo et al., 2009). In this study, the proteinuria using a dipstick and eGFR were measured at baseline (2000). Diabetes mellitus was defined as a concentration of serum fasting glucose of ≥ 126 mg/dl or the use of glucose-lowering medications. BP was measured annually with the participant in the sitting position after 5 min of rest using an automated sphygmomanometer (BP-203IIIB; Colin Corporation, Tokyo, Japan). The BP was measured two times at intervals of 1 min on the right arm, and the average value was calculated as the baseline BP.