# The association between blood pressure, renal function, and subclinical atherosclerosis in young and middle-aged non-hypertensive individuals: a mediation analysis

**Authors:** Wentao Lu, Wen Li, Zhuoqun Zou, Qinyuan Yang, Jianguang Tian

PMC · DOI: 10.3389/fcvm.2025.1613785 · Frontiers in Cardiovascular Medicine · 2025-10-20

## TL;DR

This study shows that kidney function connects blood pressure and early signs of artery disease in non-hypertensive young and middle-aged people.

## Contribution

It reveals that renal function mediates the link between blood pressure and subclinical atherosclerosis in non-hypertensive individuals.

## Key findings

- Renal function is independently linked to blood pressure and subclinical atherosclerosis.
- Glomerular filtration rate (GFR) mediates the relationship between blood pressure and brachial-ankle pulse wave velocity (baPWV).
- The mediation effect holds true for males after gender stratification.

## Abstract

This study aimed to investigate the interactions between blood pressure, renal function, and subclinical atherosclerosis in young and middle-aged individuals without hypertension.

A total of 1,590 young and middle-aged individuals without hypertension were selected from the Shanghai Health and Medical Center database. Univariate and multivariate regression analyses were used to identify risk factors associated with subclinical atherosclerosis, and a mediation analysis using the bootstrap method was conducted to assess the mediating role of renal function between blood pressure and subclinical atherosclerosis.

The multivariate linear regression analysis identified significant correlations with age, gender, diastolic blood pressure (DBP), systolic blood pressure (SBP), glomerular filtration rate (GFR), history of cardiovascular disease (CVD), glycated hemoglobin (HbA1c), smoking history, and brachial-ankle pulse wave velocity (baPWV) (P < 0.05). The results indicated that GFR mediated the relationships of both systolic blood pressure (SBP) and diastolic blood pressure (DBP) with brachial-ankle pulse wave velocity (baPWV) (P < 0.05). The same is true among males after stratification by gender.

Renal function is independently associated with blood pressure and subclinical atherosclerosis after adjusting for confounders. Moreover, renal function mediates the relationship between blood pressure and subclinical atherosclerosis, also in males.

## Linked entities

- **Diseases:** cardiovascular disease (MONDO:0004995)

## Full-text entities

- **Diseases:** CVD (MESH:D002318), hypertension (MESH:D006973), atherosclerosis (MESH:D050197)

## Full text

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## Figures

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## References

24 references — full list in the complete paper: https://tomesphere.com/paper/PMC12580273/full.md

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Source: https://tomesphere.com/paper/PMC12580273