Prognostic significance of renal function in elderly patients with isolated Systolic hypertension:: Results from the Syst-eur trial

被引:160
作者
De Leeuw, PW
Thijs, L
Birkenhäger, WH
Voyaki, SM
Efstratopoulos, AD
Fagard, RH
Leonetti, G
Nachev, C
Petrie, JC
Rodicio, JL
Rosenfeld, JJ
Sarti, C
Staessen, JA
机构
[1] Univ Maastricht, Dept Internal Med, Maastricht, Netherlands
[2] Katholieke Univ Leuven, Dept Mol & Cardiovasc Onderzoek, Hypertensie & Cardiovasc Revalidatie Eenheid, Studiecoordinatiectr, Leuven, Belgium
[3] Erasmus Univ, Rotterdam, Netherlands
[4] Gen Hosp Athens, Dept Internal Med, Athens, Greece
[5] Gen Hosp Athens, Hypertens Unit, Athens, Greece
[6] Ist Auxol Italiano, Milan, Italy
[7] Univ Milan, Osped Maggiore, Ctr Fisiol Clin & Ipertens, Milan, Italy
[8] Alexandrovs Univ Hosp, Dept Internal Med, Sofia, Bulgaria
[9] Univ Aberdeen, Dept Med & Therapeut, Aberdeen, Scotland
[10] Hosp 12 Octubre, Unidad Hypertens, E-28041 Madrid, Spain
[11] Sackler Sch Med, Tel Aviv, Israel
[12] Natl Publ Hlth Inst, Helsinki, Finland
来源
JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY | 2002年 / 13卷 / 09期
关键词
D O I
10.1097/01.ASN.0000027871.86296.92
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Several reports suggest that markers of renal function such as serum creatinine, serum uric acid, and urinary excretion of protein may be related to cardiovascular complications and mortality. This study analyzed the data from the Syst-Eur trial, which was a randomized, placebo-controlled, double-blind intervention trial in elderly patients with isolated systolic hypertension. The purpose was to evaluate whether serum levels of creatinine and uric acid and urinary protein excretion at entry are related to subsequent morbidity and mortality. Incidence rates of total mortality, cardiovascular mortality, stroke (fatal as well as nonfatal), coronary events, and all cardiovascular endpoints were calculated for each quintile of serum creatinine or serum uric acid or for each category of protein excretion (none, trace, and overt). Crude and adjusted relative hazard rates were also determined for each 20 muM increase in serum creatinine, each 50 muM increase in serum uric acid, and for each protein excretion category. Even when adjusted for age, gender, and various other covariates, serum creatinine was significantly associated with a worse prognosis. There was an U-shaped relationship between serum uric acid and total mortality, but otherwise no obvious relationships were detected between serum uric acid levels and complications when appropriate adjustments were made for confounding variables. Proteinuria at entry was a significant predictor of total mortality and all cardiovascular endpoints. It is concluded that higher levels of serum creatinine and trace or oven proteinuria are associated with an increased number of cardiovascular events and with a higher mortality in patients with isolated systolic hypertension.
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收藏
页码:2213 / 2222
页数:10
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