Preventive cardiologyChronic Kidney Disease as a Predictor of Cardiovascular Disease (from the Framingham Heart Study)
Section snippets
Methods
The Framingham Heart Study is a community-based prospective cohort study of CVD and its risk factors that began in 1948, consisting of 5,209 men and women in the original cohort.1 Subjects were invited to attend examinations every 2 years. The study sample for the present investigation consisted of original-cohort subjects attending examination cycle 15 (1977 to 1979). Of 2,632 participants attending the 15th examination cycle, 67 had missing covariate data and 94 had missing creatinine values,
Results
Mean age of our study sample was 68 years, and 58.9% were women. Mean overall follow-up was 16 years. In study subjects, 574 (23.2%) had CKD. Of these, 131 (22.8%) had stage 3b CKD. Those with CKD were older, tended to have lower mean HDL cholesterol, and had a higher prevalence of hypertension and diabetes (Table 1). Relative to those with stage 3a CKD, subjects with stage 3b CKD were older, more likely to be hypertensive and have diabetes, and had high rates of prevalent CVD. eGFR in those
Discussion
In a community-based cohort of men and women, stage 3 CKD was associated with a 20% increased risk of CVD and CHD after adjustment for age and sex, whereas stage 3b CKD was associated with a 50% increased risk of CVD, which remained significant in multivariable-adjusted models. CKD and stage 3b CKD were associated with all-cause mortality in age- and sex-adjusted models, but not after accounting for CVD risk factors and prevalent CVD. Stage 3b CKD did not constitute a CVD risk equivalent. The
Acknowledgments
Dr Fox had full access to all data in the study and takes responsibility for the integrity of the data and accuracy of the data analysis. The funding sources had no role in the study design, analyses, or drafting of the manuscript. The National Heart, Lung, and Blood Institute reviews all manuscripts submitted for publication, but was not involved in the decision to publish.
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The Framingham Heart Study was supported by the National Heart, Lung, and Blood Institute, Bethesda, Maryland (N01-HC-25195).
Dr Parikh is currently at Beth Israel Deaconess Medical Center.