PREVALENCE OF RENOVASCULAR DISEASE IN THE ELDERLY

老年人的危重肾血管疾病(RVD)可能有助于 肾功能不全由引起肾缺血引起。此外， 与危重RVD相关的高血压可能会增加 冠心病(CHD)和中风。然而，实际情况是 临界RVD的贡献(定义为直径大于60%- 减少肾动脉狭窄或闭塞)对这些重要的健康 问题是不确定的，因为老年人中RVD的患病率是 未知。有意义的流行率估计受到以下因素的限制 缺乏适用于临界RVD的筛查方法 在以人口为基础的队列中获得的准确数据。具体地说，这 该项目建议使用肾脏双功超声(RDS)来检测 存在严重的RVD。这种非侵入性超声技术允许 快速、准确地评估关键的RVD。铁路发展策略将应用于 北卡罗来纳州福赛斯县的队列来自正在进行的NHLBI- 赞助的心血管健康研究(CHS)，一项纵向人群- 老年男性和女性冠心病和中风的基础研究。作为一个四年 社区卫生服务的辅助建议、严重差饷物业估价的流行情况及其 与肾功能、亚临床心血管疾病的关系 (即颈动脉超声、超声心动图)、冠心病和中风 在项目的头两年中确定其特点。在最后一次 两年来，冠心病、中风和亚临床心血管疾病的发病率 CHS参与者的疾病表现为严重的RVD， 无肾功能不全，将具有特征性。技术的应用 RDS到CHS Forsyth县队列提供了一个独特的机会 估计严重的RVD在这一老年人群中的真实患病率。 结合人口统计数据和分析的RDS结果 作为社区卫生服务的一部分进行的测量将实现以下具体目标 这个项目不需要额外的评估。结果, 与老年人的重要健康问题有关的独特信息 将以具有成本效益的方式获得。此信息将 为进一步调查提供理由，以检查新战略或 老年危重RVD的内科和介入治疗。

Critical renovascular disease (RVD) in the elderly may contribute to renal insufficiency by causing renal ischemia. Additionally, the hypertension associated with critical RVD may increase the risk of coronary heart disease (CHD) and stroke. However, the actual contribution of critical RVD (defined as greater than 60% diameter- reducing renal artery stenosis or occlusion) to these important health issues is uncertain because the prevalence of RVD in the elderly is unknown. Meaningful prevalence estimates have been limited by the absence of suitable screening methods for critical RVD and by the absence of accurate data obtained in population-based cohort. Specifically, this project proposes the use of renal duplex sonography (RDS) to detect the presence of critical RVD. This non-invasive ultrasound technique allows rapid and accurate evaluation of critical RVD. RDS will be applied to the Forsyth County, North Carolina cohort from the ongoing NHLBI- sponsored Cardiovascular Health Study (CHS), a longitudinal population- based study of CHD and stroke in elderly men and women. As a four year ancillary proposal to CHS, the prevalence of critical RVD and its association with renal function, subclinical cardiovascular disease (i.e., carotid ultrasonography, echocardiography), CHD and stroke will be characterized during the first two years of the project. In the last two years, the incidence of CHD, stroke and subclinical cardiovascular disease in the CHS participants demonstration critical RVD, with and without renal insufficiency, will be characterized. The application of RDS to the CHS Forsyth County cohort provides a unique opportunity to estimate the true prevalence of critical RVD in this elderly population. RDS results in combination with demographic data and analytic measurements made as part of the CHS will achieve the specific aims of this project without the need for additional evaluation. As a result, unique information pertaining to important health issues in the elderly will be obtained in a cost-efficient manner. This information will provide rationale for further investigation to examine new strategies or medical and interventional management of critical RVD in the elderly.