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Reduction in Albuminuria Translates to Reduction in Cardiovascular Events in Hypertensive Patients: Losartan Intervention for Endpoint Reduction in Hypertension Study

Few data are available to clarify whether changes in albuminuria over time translate to changes in cardiovascular risk. The aim of the present study was to examine whether changes in albuminuria during 4.8 years of antihypertensive treatment were related to changes in risk in 8206 patients with hype... Full description

Journal Title: Hypertension 2005-02-01, Vol.45 (2), p.198-202
Main Author: Ibsen, Hans
Other Authors: Olsen, Michael H , Wachtell, Kristian , Borch-Johnsen, Knut , Lindholm, Lars H , Mogensen, Carl Erik , Dahlof, Bjorn , Devereux, Richard B , de Faire, Ulf , Fyhrquist, Frej , Julius, Stevo , Kjeldsen, Sverre E , Lederballe-Pedersen, Ole , Nieminen, Markku S , Omvik, Per , Oparil, Suzanne , Wan, Ying
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: United States: Am Heart Assoc
ID: ISSN: 0194-911X
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title: Reduction in Albuminuria Translates to Reduction in Cardiovascular Events in Hypertensive Patients: Losartan Intervention for Endpoint Reduction in Hypertension Study
format: Article
creator:
  • Ibsen, Hans
  • Olsen, Michael H
  • Wachtell, Kristian
  • Borch-Johnsen, Knut
  • Lindholm, Lars H
  • Mogensen, Carl Erik
  • Dahlof, Bjorn
  • Devereux, Richard B
  • de Faire, Ulf
  • Fyhrquist, Frej
  • Julius, Stevo
  • Kjeldsen, Sverre E
  • Lederballe-Pedersen, Ole
  • Nieminen, Markku S
  • Omvik, Per
  • Oparil, Suzanne
  • Wan, Ying
subjects:
  • 80 and over
  • Aged
  • Aged, 80 and over
  • Albuminuria - physiopathology
  • Antihypertensive Agents - therapeutic use
  • Atenolol - therapeutic use
  • Cardiovascular Diseases - etiology
  • Creatinine - urine
  • Female
  • Humans
  • Hypertension - drug therapy
  • Hypertension - urine
  • Hypertension/drug therapy/urine
  • Losartan - therapeutic use
  • Male
  • MEDICAL AND HEALTH SCIENCES
  • MEDICIN OCH HÄLSOVETENSKAP
  • Middle Aged
  • Predictive Value of Tests
  • Proportional Hazards Models
  • Risk Factors
  • Severity of Illness Index
ispartof: Hypertension, 2005-02-01, Vol.45 (2), p.198-202
description: Few data are available to clarify whether changes in albuminuria over time translate to changes in cardiovascular risk. The aim of the present study was to examine whether changes in albuminuria during 4.8 years of antihypertensive treatment were related to changes in risk in 8206 patients with hypertension and left ventricular hypertrophy in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) study. Urinary albumin/creatinine ratio (UACR) was measured at baseline and annually. Time-varying albuminuria was closely related to risk for the primary composite end point (ie, when UACR decreased during treatment, risk was reduced accordingly). When the population was divided according to median baseline value (1.21 mg/mmol) and median year 1 UACR (0.67 mg/mmol), risk increased stepwise and significantly for the primary composite end point from those with low baseline/low year 1 (5.5%), to low baseline/high year 1 (8.6%), to high baseline/low year 1 (9.4%), and to high baseline/high year 1 (13.5%) values. Similar significant, stepwise increases in risk were seen for the components of the primary composite end point (cardiovascular mortality, stroke, and myocardial infarction). The observation that changes in UACR during antihypertensive treatment over time translated to changes in risk for cardiovascular morbidity and mortality was not explained by in-treatment level of blood pressure. We propose that monitoring of albuminuria should be an integrated part of the management of hypertension. If albuminuria is not decreased by the patient’s current antihypertensive and other treatment, further intervention directed toward blood pressure control and other modifiable risks should be considered.
language: eng
source:
identifier: ISSN: 0194-911X
fulltext: no_fulltext
issn:
  • 0194-911X
  • 1524-4563
  • 1524-4563
url: Link


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titleReduction in Albuminuria Translates to Reduction in Cardiovascular Events in Hypertensive Patients: Losartan Intervention for Endpoint Reduction in Hypertension Study
creatorIbsen, Hans ; Olsen, Michael H ; Wachtell, Kristian ; Borch-Johnsen, Knut ; Lindholm, Lars H ; Mogensen, Carl Erik ; Dahlof, Bjorn ; Devereux, Richard B ; de Faire, Ulf ; Fyhrquist, Frej ; Julius, Stevo ; Kjeldsen, Sverre E ; Lederballe-Pedersen, Ole ; Nieminen, Markku S ; Omvik, Per ; Oparil, Suzanne ; Wan, Ying
creatorcontribIbsen, Hans ; Olsen, Michael H ; Wachtell, Kristian ; Borch-Johnsen, Knut ; Lindholm, Lars H ; Mogensen, Carl Erik ; Dahlof, Bjorn ; Devereux, Richard B ; de Faire, Ulf ; Fyhrquist, Frej ; Julius, Stevo ; Kjeldsen, Sverre E ; Lederballe-Pedersen, Ole ; Nieminen, Markku S ; Omvik, Per ; Oparil, Suzanne ; Wan, Ying ; Hjärt-kärlinstitutionen ; Sahlgrenska akademin ; Göteborgs universitet ; Gothenburg University ; Cardiovascular Institute ; Sahlgrenska Academy
descriptionFew data are available to clarify whether changes in albuminuria over time translate to changes in cardiovascular risk. The aim of the present study was to examine whether changes in albuminuria during 4.8 years of antihypertensive treatment were related to changes in risk in 8206 patients with hypertension and left ventricular hypertrophy in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) study. Urinary albumin/creatinine ratio (UACR) was measured at baseline and annually. Time-varying albuminuria was closely related to risk for the primary composite end point (ie, when UACR decreased during treatment, risk was reduced accordingly). When the population was divided according to median baseline value (1.21 mg/mmol) and median year 1 UACR (0.67 mg/mmol), risk increased stepwise and significantly for the primary composite end point from those with low baseline/low year 1 (5.5%), to low baseline/high year 1 (8.6%), to high baseline/low year 1 (9.4%), and to high baseline/high year 1 (13.5%) values. Similar significant, stepwise increases in risk were seen for the components of the primary composite end point (cardiovascular mortality, stroke, and myocardial infarction). The observation that changes in UACR during antihypertensive treatment over time translated to changes in risk for cardiovascular morbidity and mortality was not explained by in-treatment level of blood pressure. We propose that monitoring of albuminuria should be an integrated part of the management of hypertension. If albuminuria is not decreased by the patient’s current antihypertensive and other treatment, further intervention directed toward blood pressure control and other modifiable risks should be considered.
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subject80 and over ; Aged ; Aged, 80 and over ; Albuminuria - physiopathology ; Antihypertensive Agents - therapeutic use ; Atenolol - therapeutic use ; Cardiovascular Diseases - etiology ; Creatinine - urine ; Female ; Humans ; Hypertension - drug therapy ; Hypertension - urine ; Hypertension/drug therapy/urine ; Losartan - therapeutic use ; Male ; MEDICAL AND HEALTH SCIENCES ; MEDICIN OCH HÄLSOVETENSKAP ; Middle Aged ; Predictive Value of Tests ; Proportional Hazards Models ; Risk Factors ; Severity of Illness Index
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1Olsen, Michael H
2Wachtell, Kristian
3Borch-Johnsen, Knut
4Lindholm, Lars H
5Mogensen, Carl Erik
6Dahlof, Bjorn
7Devereux, Richard B
8de Faire, Ulf
9Fyhrquist, Frej
10Julius, Stevo
11Kjeldsen, Sverre E
12Lederballe-Pedersen, Ole
13Nieminen, Markku S
14Omvik, Per
15Oparil, Suzanne
16Wan, Ying
17Hjärt-kärlinstitutionen
18Sahlgrenska akademin
19Göteborgs universitet
20Gothenburg University
21Cardiovascular Institute
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0Reduction in Albuminuria Translates to Reduction in Cardiovascular Events in Hypertensive Patients: Losartan Intervention for Endpoint Reduction in Hypertension Study
1Hypertension
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descriptionFew data are available to clarify whether changes in albuminuria over time translate to changes in cardiovascular risk. The aim of the present study was to examine whether changes in albuminuria during 4.8 years of antihypertensive treatment were related to changes in risk in 8206 patients with hypertension and left ventricular hypertrophy in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) study. Urinary albumin/creatinine ratio (UACR) was measured at baseline and annually. Time-varying albuminuria was closely related to risk for the primary composite end point (ie, when UACR decreased during treatment, risk was reduced accordingly). When the population was divided according to median baseline value (1.21 mg/mmol) and median year 1 UACR (0.67 mg/mmol), risk increased stepwise and significantly for the primary composite end point from those with low baseline/low year 1 (5.5%), to low baseline/high year 1 (8.6%), to high baseline/low year 1 (9.4%), and to high baseline/high year 1 (13.5%) values. Similar significant, stepwise increases in risk were seen for the components of the primary composite end point (cardiovascular mortality, stroke, and myocardial infarction). The observation that changes in UACR during antihypertensive treatment over time translated to changes in risk for cardiovascular morbidity and mortality was not explained by in-treatment level of blood pressure. We propose that monitoring of albuminuria should be an integrated part of the management of hypertension. If albuminuria is not decreased by the patient’s current antihypertensive and other treatment, further intervention directed toward blood pressure control and other modifiable risks should be considered.
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titleReduction in Albuminuria Translates to Reduction in Cardiovascular Events in Hypertensive Patients: Losartan Intervention for Endpoint Reduction in Hypertension Study
authorIbsen, Hans ; Olsen, Michael H ; Wachtell, Kristian ; Borch-Johnsen, Knut ; Lindholm, Lars H ; Mogensen, Carl Erik ; Dahlof, Bjorn ; Devereux, Richard B ; de Faire, Ulf ; Fyhrquist, Frej ; Julius, Stevo ; Kjeldsen, Sverre E ; Lederballe-Pedersen, Ole ; Nieminen, Markku S ; Omvik, Per ; Oparil, Suzanne ; Wan, Ying
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abstractFew data are available to clarify whether changes in albuminuria over time translate to changes in cardiovascular risk. The aim of the present study was to examine whether changes in albuminuria during 4.8 years of antihypertensive treatment were related to changes in risk in 8206 patients with hypertension and left ventricular hypertrophy in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) study. Urinary albumin/creatinine ratio (UACR) was measured at baseline and annually. Time-varying albuminuria was closely related to risk for the primary composite end point (ie, when UACR decreased during treatment, risk was reduced accordingly). When the population was divided according to median baseline value (1.21 mg/mmol) and median year 1 UACR (0.67 mg/mmol), risk increased stepwise and significantly for the primary composite end point from those with low baseline/low year 1 (5.5%), to low baseline/high year 1 (8.6%), to high baseline/low year 1 (9.4%), and to high baseline/high year 1 (13.5%) values. Similar significant, stepwise increases in risk were seen for the components of the primary composite end point (cardiovascular mortality, stroke, and myocardial infarction). The observation that changes in UACR during antihypertensive treatment over time translated to changes in risk for cardiovascular morbidity and mortality was not explained by in-treatment level of blood pressure. We propose that monitoring of albuminuria should be an integrated part of the management of hypertension. If albuminuria is not decreased by the patient’s current antihypertensive and other treatment, further intervention directed toward blood pressure control and other modifiable risks should be considered.
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pubAm Heart Assoc
pmid15655123
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