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Eur Heart J. 2007 Jul;28(14):1739-45. Epub 2007 May 11.

Low-grade albuminuria and the incidence of heart failure in a community-based cohort of elderly men.

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  • 1Section of Geriatrics, Department of Public Health and Caring Sciences, Uppsala University, Uppsala Science Park, Uppsala, Sweden.

Abstract

AIMS:

To investigate associations of urinary albumin excretion rate (UAER) and heart failure (HF) incidence in a community-based sample.

METHODS AND RESULTS:

In a prospective study of 70-year-old men free from HF at baseline (n = 1106), UAER (from timed overnight samples) was analysed with established risk factors for HF [acute MI before baseline, acute MI during follow-up (modelled as a time-dependent covariate), hypertension, diabetes, left ventricular hypertrophy, smoking, body mass index, and glomerular filtration rate] and more recently described risk factors [high-sensitive C-reactive protein and insulin sensitivity (clamp glucose disposal rate)] as predictors of HF incidence. Ninety-eight participants developed HF during a median follow-up of 9.0 years. In Cox proportional hazards models adjusted for established and novel risk factors for HF, a 1 SD increase in log UAER increased the risk of HF in individuals without anti-hypertensive treatment (hazard ratio 1.49; 95% CI 1.13-1.98; P = 0.005). Furthermore, UAER remained an independent predictor of HF, also in participants without diabetes at baseline or myocardial infarction at baseline or during follow-up. There were no significant associations between UAER and HF incidence in individuals with anti-hypertensive treatment.

CONCLUSION:

Our observations support the notion that low-grade albuminuria is a marker for subclinical cardiovascular damage that predisposes to future HF in the community.

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PMID:
17495987
[PubMed - indexed for MEDLINE]
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