Renovascular disease and the risk of adverse coronary events in the elderly - A prospective, population-based study

被引:103
作者
Edwards, MS
Craven, TE
Burke, GL
Dean, RH
Hansen, KJ
机构
[1] Wake Forest Univ, Sch Med, Dept Gen Surg, Div Surg Sci,Sect Vasc Surg, Winston Salem, NC 27157 USA
[2] Wake Forest Univ, Sch Med, Dept Publ Hlth Sci, Winston Salem, NC 27157 USA
关键词
D O I
10.1001/archinte.165.2.207
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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.
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页码:207 / 213
页数:7
相关论文
共 37 条
[1]   THE ELECTROCARDIOGRAM IN POPULATION STUDIES - A CLASSIFICATION SYSTEM [J].
BLACKBURN, H ;
KEYS, A ;
SIMONSON, E ;
RAUTAHARJU, P ;
PUNSAR, S .
CIRCULATION, 1960, 21 (06) :1160-1175
[2]   Renal artery reconstruction for the preservation of renal function [J].
Cambria, RP ;
Brewster, DC ;
LItalien, GJ ;
Gertler, JP ;
Abbott, WM ;
LaMuraglia, GM ;
Moncure, AC ;
Vignati, J ;
Bazari, H ;
Fang, LT ;
Atamian, S .
JOURNAL OF VASCULAR SURGERY, 1996, 24 (03) :371-380
[3]  
Chábová V, 2000, MAYO CLIN PROC, V75, P437
[4]   Surgical management of atherosclerotic renovascular disease [J].
Cherr, GS ;
Hansen, KJ ;
Craven, TE ;
Edwards, MS ;
Ligush, J ;
Levy, PJ ;
Freedman, BI ;
Dean, RH .
JOURNAL OF VASCULAR SURGERY, 2002, 35 (02) :236-245
[5]  
Conlon PJ, 1998, J AM SOC NEPHROL, V9, P252
[6]  
DEAN RH, 1981, ARCH SURG-CHICAGO, V116, P1408
[7]   Renal insufficiency as a predictor of cardiovascular outcomes and mortality in elderly individuals [J].
Fried, LF ;
Shlipak, MG ;
Crump, C ;
Bleyer, AJ ;
Gottdiener, JS ;
Kronmal, RA ;
Kuller, LH ;
Newman, AB .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2003, 41 (08) :1364-1372
[8]  
Fried Linda P., 1991, Annals of Epidemiology, V1, P263
[9]   MAJOR ELECTROCARDIOGRAPHIC ABNORMALITIES IN PERSONS AGED 65 YEARS AND OLDER (THE CARDIOVASCULAR HEALTH STUDY) [J].
FURBERG, CD ;
MANOLIO, TA ;
PSATY, BM ;
BILD, DE ;
BORHANI, NO ;
NEWMAN, A ;
TABATZNIK, B ;
RAUTAHARJU, PM .
AMERICAN JOURNAL OF CARDIOLOGY, 1992, 69 (16) :1329-1335
[10]  
Gardin J M, 1992, J Am Soc Echocardiogr, V5, P63