Proteinuria as a risk factor for cardiovascular disease and mortality in older people: A prospective study
Proteinuria as a risk factor for cardiovascular disease and mortality in older people: A prospective study
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DOI：
10.1016/s0002-9343(00)00444-7
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发表时间：
2000-07-01
影响因子：
5.9
通讯作者：
Levy, D
中科院分区：
文献类型：
--
作者：
Culleton, BF;Larson, MG;Levy, D
背景：蛋白尿在老年人中的预后意义尚未明确。我们研究了蛋白尿与冠心病事件、心血管死亡率和老年人全因死亡率之间的关系。受试者和方法：1,045名男性（平均[+/- SD]年龄68 +/- 7岁）和1,541名女性（平均年龄69 +/- 7岁）参加了第15届心脏病研究两年一次的检查。参与者按蛋白尿的级别分为：无（85.3%），微量（10.2%）和超过微量（4.5%）。考克斯比例风险分析被用来确定基线蛋白尿的关系，指定的结果，调整其他危险因素，包括血清肌酐level.Results：在17年的后续行动，有455冠心病事件，412心血管疾病死亡，1,214死亡。在男性中，基线蛋白尿与全因死亡率相关（微量蛋白尿的风险比[HR] = 1.3，95%置信区间[CI] 1.0 - 1.7;高于微量蛋白尿的风险比[HR]= 1.3，95% CI 1.0 - 1.8;趋势P = 0.02）。在女性中，微量蛋白尿与心血管疾病死亡（HR = 1.6，95%CI 1.1至2.4）和全因死亡率（HR = 1.4，95%CI 1.1至1.7）相关。结论：蛋白尿是男性和女性全因死亡率以及女性心血管疾病死亡率的重要危险因素，尽管相对较弱。美国医学杂志2000;109：1-8。(C)2000年出版，Excerpta Medica，Inc.
BACKGROUND: The prognostic significance of proteinuria in older people is not well defined. We examined the associations between proteinuria and incident coronary heart disease, cardiovascular mortality, and all-cause mortality in older people.SUBJECTS AND METHODS: Casual dipstick proteinuria was determined in 1,045 men (mean [+/- SD] age 68 +/- 7 years) and 1,541 women (mean age 69 +/- 7 years) attending the 15th biennial examination of the Framingham Heart Study. Participants were divided by grade of proteinuria: none (85.3%), trace (10.2%), and greater-than-trace (4.5%). Cox proportional hazards analyses were used to determine the relations of baseline proteinuria to the specified outcomes, adjusting for other risk factors, including serum creatinine level.RESULTS: During 17 years of follow-up, there were 455 coronary heart disease events, 412 cardiovascular disease deaths, and 1,214 deaths. In men, baseline proteinuria was associated with all-cause mortality (hazards ratio [HR] = 1.3, 95% confidence interval [CI] 1.0 to 1.7 for trace proteinuria; HR = 1.3, 95% CI 1.0 to 1.8 for greater-than-trace proteinuria; P for trend = 0.02). In women, trace proteinuria was associated with cardiovascular disease death (HR = 1.6, 95% CI 1.1 to 2.4), and all-cause mortality (HR = 1.4, 95% CI 1.1 to 1.7).CONCLUSION: Proteinuria is a significant, although relatively weak, risk factor for all-cause mortality in men and women, and for cardiovascular disease mortality in women. Am J Med. 2000;109:1-8. (C) 2000 by Excerpta Medica, Inc.