Online only: Traditional risk factors best in predicting heart disease death for some older people
New study findings show that traditional heart disease risk factors are more strongly associated with risk of death from cardiovascular disease than newer, emerging risk factors in older people with chronic kidney disease.
Study participants with chronic kidney disease who also had diabetes, systolic high blood pressure, or left ventricular hypertrophy, or were smokers or exhibited low physical activity had an increased risk of death from cardiovascular causes. However, for these patients, emerging risk factors such as elevated levels of C-reactive protein, fibrinogen, and the blood clotting protein factor VIIIc were not as strongly associated with greater risk of cardiovascular death. Results from the National Heart, Lung, and Blood Institute-funded Cardiovascular Health Study were published in the April 13 issue of the Journal of the American Medical Association.
"The message from this study is clear: to reduce heart disease and stroke deaths in older people with chronic kidney disease, we need to target and control traditional risk factors," said Teri Manolio, MD, PhD, director of the National Heart, Lung and Blood Institute’s Epidemiology and Biometry Program and a study co-author. Manolio added that many proven, effective interventions are available for reducing these risk factors including adequate control of high blood glucose and high blood pressure, increasing physical activity and stopping smoking.
Chronic kidney disease is a known, controllable risk factor for heart disease, and its incidence is on the rise. An estimated 4.5 percent of adults have physiological evidence of chronic kidney disease. The rate of kidney failure in the United States has doubled in the past decade. Chronic kidney disease was defined in the study by an estimated glomerular filtration rate of less than 60ml/min/1.732, a measure of how well the kidneys are filtering waste from blood. The study defined cardiovascular mortality as death from heart disease, heart failure, peripheral vascular disease and stroke.
The Cardiovascular Health Study is a longitudinal study of traditional and emerging risk factors for death from cardiovascular diseases in more than 5,800 men and women older than age 65 in four U.S. communities: Forsyth County, N.C.; Sacramento County, Calif.; Washington County, Md.; and Pittsburgh. Participants were followed for an average of 8.6 years.
For more information about chronic kidney disease, visit the National Institute of Diabetes and Digestive and Kidney Diseases at www.niddk.nih.gov .
Story courtesy National Heart, Lung and Blood Institute, April 12, 2005
This story does not contain original reporting from The Nation’s Health staff
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