Traditional Risk Factors are
Better than Emerging Risk Factors in Predicting Heart
Disease Death in Older People with Chronic Kidney
Disease
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.
These results from the National Heart, Lung, and Blood
Institute-funded Cardiovascular Health Study will
be published in the April 13 issue of the Journal
of the American Medical Association.
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.
“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,
M.D., Ph.D., director of NHLBI’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 U.S. has doubled in the past decade.
Chronic kidney disease was defined in the study by
an estimated glomerular filtration rate (GFR) 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 over 5,800 men
and women over the age of 65 in four U.S. communities:
Forsyth County, NC; Sacramento County, CA; Washington
County, MD; and Pittsburgh, PA. Participants were
followed for an average of 8.6 years.
Dr. Manolio is available to comment on these and other
study findings. To schedule an interview, please call
the NHLBI Communications Office at (301) 496-4236
or email at nhlbi_news@nhlbi.nih.gov.
For more information about chronic kidney disease,
visit the National Institute of Diabetes and Digestive
and Kidney Diseases at www.nkdep.nih.gov
NHLBI is part of the National Institutes of Health
(NIH), the Federal Government's primary agency for
biomedical and behavioral research. NIH is a component
of the U.S. Department of Health and Human Services.
Additional information about cardiovascular disease
and NHLBI-supported research and educational programs
are available online at the NHLBI website, www.nhlbi.nih.gov.
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