Document Detail


Aortic valve sclerosis and albuminuria predict cardiovascular events independently in hypertension: a losartan intervention for endpoint-reduction in hypertension (LIFE) substudy.
MedLine Citation:
PMID:  16280277     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of hypertension     Volume:  18     ISSN:  0895-7061     ISO Abbreviation:  Am. J. Hypertens.     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2005-11-10     Completed Date:  2005-12-21     Revised Date:  2009-02-24    
Medline Journal Info:
Nlm Unique ID:  8803676     Medline TA:  Am J Hypertens     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1430-6     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Glostrup University Hospital, Glostrup, Denmark. mho@dadlnet.dk
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MeSH Terms
Descriptor/Qualifier:
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:
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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