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Chronic renal insufficiency and cardiovascular events in the elderly: findings from the Cardiovascular Health Study.

TitleChronic renal insufficiency and cardiovascular events in the elderly: findings from the Cardiovascular Health Study.
Publication TypeJournal Article
Year of Publication2004
AuthorsShlipak, MG, Fried, LF, Stehman-Breen, C, Siscovick, D, Newman, AB
JournalAm J Geriatr Cardiol
Volume13
Issue2
Pagination81-90
Date Published2004 Mar-Apr
ISSN1076-7460
KeywordsAged, Blood Coagulation Factors, Cardiovascular Diseases, Chronic Disease, Creatinine, Cystatin C, Cystatins, Female, Fibrinogen, Geriatric Assessment, Humans, Incidence, Male, Prevalence, Renal Insufficiency, Risk Factors
Abstract<p>In the Cardiovascular Health Study, the authors sought to evaluate the impact of chronic renal insufficiency (CRI) on cardiovascular risk status and outcomes in a representative sample of community-dwelling elderly adults. Defined as a serum creatinine level > or =1.3 mg/dL in women and > or =1.5 mg/dL in men, CRI was present in 647 (11%) of 5808 participants. At baseline, the prevalence of clinical or subclinical cardiovascular disease was 64% in participants with CRI and 43% in those without CRI (odds ratio, 2.34; 95% confidence interval, 1.96-2.80). The incidence of cardiovascular disease events during follow-up was 3% per year in participants with creatinine levels <1.10 mg/dL and increased steadily to reach 7% per year in those with creatinine > or =1.70 mg/dL. Among the possible mediators for the association between CRI and cardiovascular morbidity are inflammatory (C-reactive protein, fibrinogen, and interleukin-6) and hemostatic (factor VII, factor VIII, plasmin-antiplasmin product, and D-dimer) biomarkers, all of which were significantly elevated in Cardiovascular Health Study participants with CRI. Future studies should evaluate the contribution of novel and traditional cardiovascular risk factors to the cardiovascular risk of elderly persons with CRI. The identification of CRI in the elderly and the use of cardiovascular prevention therapies represent a major opportunity to reduce their burden of cardiovascular morbidity.</p>
DOI10.1111/j.1076-7460.2004.02125.x
Alternate JournalAm J Geriatr Cardiol
PubMed ID15010654