| Aortic valve sclerosis and albuminuria predict cardiovascular events independently in hypertension: a losartan intervention for endpoint-reduction in hypertension (LIFE) substudy. | |
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MedLine Citation:
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PMID: 16280277 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Aortic valve (AV) sclerosis and urine albumin/creatinine ratio (UACR) are both markers of atherosclerosis. We aimed to investigate whether they predicted cardiovascular (CV) events independently in patients with hypertension and electrocardiographic left ventricular (LV) hypertrophy. METHODS: After 2 weeks of placebo treatment, clinical, laboratory, and echocardiographic variables were assessed in 960 hypertensive patients from the LIFE Echo substudy who had electrocardiographic LV hypertrophy. Morning urine albumin and creatinine were measured calculating UACR. The presence of AV sclerosis was defined as valve thickening or calcification. Fifteen patients with mild AV stenosis were excluded. The patients were followed for 60 +/- 4 months and the composite endpoint (CEP) of CV death, nonfatal stroke, or nonfatal myocardial infarction was recorded. RESULTS: A value of UACR above the median value of 1.406 was associated with higher incidence of CEP and CV death in patients with AV sclerosis (CEP: 18.8% v 9.0% P < 0.05, CV death: 7.1% v 0.7% P < 0.01) and in patients without AV sclerosis (CEP: 14.0% v 4.9% P < 0.001, CV death: 5.1% v 1.1% P < 0.01). In Cox regression analysis, AV sclerosis predicted CEP (hazard ratio [HR] = 1.52, P < .05), but not CV death (HR = 1.30 [0.62 to 2.70], NS) independently of logUACR (HR = 1.70 and HR = 3.25, both P < .001). After adjusting for the Framingham Risk Score, CV disease, diabetes, smoking, and treatment allocation, AV sclerosis predicted CEP (HR = 1.5, P < .05) but not CV death (HR = 1.4, NS) independently of logUACR (HR = 1.2, P = .09 and HR = 1.94, P < .05). CONCLUSIONS: In hypertensive patients with electrocardiographic LV hypertrophy, AV sclerosis predicted CEP but not CV death independently of UACR after adjusting for CV risk factors and treatment allocation, indicating that AV sclerosis and UACR might be markers of different aspects of the atherosclerotic process. |
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Authors:
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Michael H Olsen; Kristian Wachtell; Jonathan N Bella; Vittorio Palmieri; Eva Gerdts; Gunnar Smith; Markku S Nieminen; Björn Dahlöf; Hans Ibsen; Richard B Devereux |
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Publication Detail:
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Type: Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: American journal of hypertension Volume: 18 ISSN: 0895-7061 ISO Abbreviation: Am. J. Hypertens. Publication Date: 2005 Nov |
Date Detail:
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Created Date: 2005-11-10 Completed Date: 2005-12-21 Revised Date: 2009-02-24 |
Medline Journal Info:
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Nlm Unique ID: 8803676 Medline TA: Am J Hypertens Country: United States |
Other Details:
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Languages: eng Pagination: 1430-6 Citation Subset: IM |
Affiliation:
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Department of Internal Medicine, Glostrup University Hospital, Glostrup, Denmark. mho@dadlnet.dk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Albuminuria / urine* Antihypertensive Agents / therapeutic use Aortic Valve / pathology* Atenolol / therapeutic use Cardiovascular Diseases / etiology*, pathology Double-Blind Method Electrocardiography Follow-Up Studies Humans Hypertension / complications, drug therapy*, urine Hypertrophy, Left Ventricular / complications, diagnosis Losartan / therapeutic use Middle Aged Predictive Value of Tests Prognosis Risk Factors Sclerosis Survival Analysis Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Antihypertensive Agents; 114798-26-4/Losartan; 29122-68-7/Atenolol |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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