Renovascular disease and the risk of adverse coronary events in the elderly - A prospective, population-based study
Renovascular disease and the risk of adverse coronary events in the elderly - A prospective, population-based study
复制标题
DOI：
10.1001/archinte.165.2.207
复制
发表时间：
2005-01-24
影响因子：
--
通讯作者：
Hansen, KJ
中科院分区：
文献类型：
--
作者：
Edwards, MS;Craven, TE;Hansen, KJ
背景：肾血管疾病是继发性高血压和肾功能不全的原因，被怀疑是冠心病发病率和死亡率的重要因素。本研究以美国老年人为样本，前瞻性地研究了肾血管疾病和不良冠状动脉事件之间的关系。方法：心血管健康研究是一项前瞻性、多中心队列研究，研究65岁以上美国人心血管疾病的危险因素、发病率和死亡率。在1995年1月至1997年2月间，对870例患者进行了肾脏超声检查。肾血管性疾病定义为任何局灶性峰值收缩速度大于或等于1.8 m/s（肾动脉狭窄），或成像动脉没有多普勒移位信号（肾动脉闭塞）。不良冠状动脉事件定义为住院心绞痛、致死性或非致死性心肌梗死和冠状动脉血运重建术。结果：在平均14个月的随访期间，68名参与者经历了一次或复发的不良冠状动脉事件。肾血管疾病的存在与不良冠状动脉事件有显著关系（危险比1.96；95%可信区间1.00- 3.83；P= 0.05），在控制了影响后仍然存在；并发动脉粥样硬化危险因素和流行心血管疾病的研究。肾血管疾病和不良冠状动脉事件之间的关系不依赖于血压升高的影响。结论：在该样本中，肾血管疾病的存在与不良冠状动脉事件的风险增加有关。风险的增加不依赖于相关的动脉粥样硬化危险因素、其他流行的心血管疾病或血压升高的影响。
Background: Renovascular disease is a cause of secondary hypertension and renal insufficiency and is suspected to contribute to morbidity and mortality of coronary heart disease. This investigation prospectively examined associations between renovascular disease and adverse coronary events among a population-based sample of elderly Americans.Methods: The Cardiovascular Health Study, is a prospective, multicenter cohort study, of cardiovascular disease risk factors, morbidity, and mortality among Americans older than 65 years. Renal duplex sonography was performed on 870 individuals between January 1995 and February 1997. Renovascular disease was defined as any focal peak systolic velocity of 1.8 m/s or greater (renal artery stenosis) or the absence of a Doppler-shifted signal from an imaged artery (renal artery occlusion). Adverse coronary events were defined as hospitalized angina, fatal or nonfatal myocardial infarction, and coronary revascularization.Results: During a mean follow-up of 14 months, 68 participants experienced incident or recurrent adverse coronary events. The presence of renovascular disease demonstrated a significant relationship with adverse coronary events (hazard ratio, 1.96; 95% confidence interval, 1.00- 3.83; P=.05) that remained after controlling for the effects; of coexisting atherosclerotic risk factors and prevalent cardiovascular disease. The relationship between renovascular disease and adverse coronary events was not dependent on the effects of increased blood pressure.Conclusions: The presence of renovascular disease was associated with an increase in the risk of adverse coronary events in this sample. The increment in risk was not dependent on the effects of associated atherosclerotic risk factors, other prevalent cardiovascular disease, or increased blood pressure.