Traditional risk factors best predictor of CVD death in kidney patients

New study findings show that traditional heart disease risk factors are more strongly associated with risk of death from cardiovascular disease than newer, emerging risk factors in older people with chronic kidney disease. These results from the National Heart, Lung, and Blood Institute-funded Cardiovascular Health Study will be published in the April 13 issue of the Journal of the American Medical Association.

Study participants with chronic kidney disease who also had diabetes, systolic high blood pressure, or left ventricular hypertrophy, or were smokers or exhibited low physical activity had an increased risk of death from cardiovascular causes. However, for these patients, emerging risk factors such as elevated levels of C-reactive protein, fibrinogen, and the blood clotting protein factor VIIIc were not as strongly associated with greater risk of cardiovascular death.

“The message from this study is clear: to reduce heart disease and stroke deaths in older people with chronic kidney disease, we need to target and control traditional risk factors,” said Teri Manolio, M.D., Ph.D., director of NHLBI’s Epidemiology and Biometry Program and a study co-author. Manolio added that many proven, effective interventions are available for reducing these risk factors including adequate control of high blood glucose and high blood pressure, increasing physical activity, and stopping smoking.

Chronic kidney disease is a known, controllable risk factor for heart disease and its incidence is on the rise. An estimated 4.5 percent of adults have physiological evidence of chronic kidney disease. The rate of kidney failure in the U.S. has doubled in the past decade. Chronic kidney disease was defined in the study by an estimated glomerular filtration rate (GFR) of less than 60ml/min/1.732, a measure of how well the kidneys are filtering waste from blood. The study defined cardiovascular mortality as death from heart disease, heart failure, peripheral vascular disease, and stroke.

The Cardiovascular Health Study is a longitudinal study of traditional and emerging risk factors for death from cardiovascular diseases in over 5,800 men and women over the age of 65 in four U.S. communities: Forsyth County, NC; Sacramento County, CA; Washington County, MD; and Pittsburgh, PA. Participants were followed for an average of 8.6 years.