J Korean Med Sci.  2009 Jan;24(Suppl 1):S50-S56. 10.3346/jkms.2009.24.S1.S50.

The Bilirubin Level is Negatively Correlated with the Incidence of Hypertension in Normotensive Korean Population

• Chin HJ
• Song YR
• Kim HS
• Park M
• Yoon HJ
• Na KY
• Kim Y
• Chae DW
• Kim S

• KMID: 1778140
• DOI: http://doi.org/10.3346/jkms.2009.24.S1.S50

Abstract

Reactive oxygen species have been known to be an important factor in the pathogenesis of hypertension. Bilirubin, one of the metabolites of heme degraded by heme oxygenase, is a potent anti-oxidant. We verified the effect of serum bilirubin level on the incidence of hypertension in normotensive subjects. We grouped 1,208 normotensive subjects by the criterion of the highest quintile value of serum bilirubin, 1.1 mg/dL. The incidence of hypertension was higher in group 1 with bilirubin less than 1.1 mg/ dL than in group 2 with bilirubin 1.1 mg/dL or more (186/908 vs. 43/300, p=0.018). The relative risk for hypertension was 0.71 (95% confidence interval, 0.51-0.99), p=0.048 in group 2 compared to group 1 by Cox's proportional hazard model. Among the groups stratified by gender, smoking, and liver function status, the group 2 showed a lower risk of hypertension in females and in non-smokers. In conclusion, a mild increase within the physiological range of serum bilirubin concentration was negatively correlated with the incidence of hypertension. The effect of bilirubin on the development of hypertension was more evident in females and in non-smokers.

Keyword

Hypertension; Hyperbilirubinemia; Risk Factor

MeSH Terms

Adult
Bilirubin/*blood
Blood Pressure
Female
Heme/chemistry
Heme Oxygenase (Decyclizing)/metabolism
Humans
Hypertension/*blood/*epidemiology
Korea
Male
Middle Aged
Proportional Hazards Models
Questionnaires
Risk
Smoking

Figure

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  Fig. 1 Selection of study subjects.

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  Fig. 2 The probability of normotension in subjects. Group 1, subjects with initial bilirubin less than 1.1 mg/dL; Group 2, subjects with initial bilirubin 1.1 mg/dL or more. Number under the graph, subjects' number at the given period.

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  Fig. 3 The probability of normotension according to gender. Group 1, subjects with initial bilirubin less than 1.1 mg/dL; Group 2, subjects with initial bilirubin 1.1 mg/dL or more. (A) Kaplan-Meier analysis in female subjects. (B) Kaplan-Meier analysis in male subjects. Number under the graph: subjects' number at the given period.

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