DOES MILD-TO-MODERATE ESSENTIAL HYPERTENSION LEAD TO RENAL FAILURE?
The risk of ESRD associated with nonmalignant hypertension has been investigated only recently. The majority of studies assessing this issue have been short-term evaluations of small sample size and post hoc analyses of epidemiologic observations. Although these studies have been criticized because of various limitations, an increasing amount of evidence links mild-to-moderate essential hypertension with the development of ESRD Table 113,14,15,16,17,18,19,20,21,22. Three large cohort studies have reported that elevated BP predicts remote risk of renal failure. Klag et al16 analyzed data from 332,544 men who were screened for the Multiple Risk Factor Intervention Trial, and Tozawa et al19 evaluated data from 98,759 men and women who were screened in Okinawa, Japan. Both studies showed an increasing relationship between baseline BP, from the high-normal stage, and the risk of ESRD 16 to 17 years later. Because renal function was not carefully evaluated at baseline in the Multiple Risk Fa
