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Prevalence of microalbuminuria and associated electrocardiographic abnormalities in an Indo-Asian population

Background. Microalbuminuria (MA) is a known predictor of cardiovascular disease (CVD) in European origin populations, but such data are lacking in native Indo-Asian populations, where CVD risks are high. Major electrocardiographic (ECG) changes are predictive of cardiovascular mortality. We determi...

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Autores principales: Jafar, Tazeen H., Qadri, Zeeshan, Hashmi, Shiraz
Formato: Texto
Lenguaje:English
Publicado: Oxford University Press 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2698093/
https://www.ncbi.nlm.nih.gov/pubmed/19225011
http://dx.doi.org/10.1093/ndt/gfp042
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author Jafar, Tazeen H.
Qadri, Zeeshan
Hashmi, Shiraz
author_facet Jafar, Tazeen H.
Qadri, Zeeshan
Hashmi, Shiraz
author_sort Jafar, Tazeen H.
collection PubMed
description Background. Microalbuminuria (MA) is a known predictor of cardiovascular disease (CVD) in European origin populations, but such data are lacking in native Indo-Asian populations, where CVD risks are high. Major electrocardiographic (ECG) changes are predictive of cardiovascular mortality. We determined the association of MA with major ECG changes in the general population of Pakistan. Methods. A total of 3143 subjects aged ≥40 years from 12 randomly selected communities in Karachi participated. MA was defined as the urine albumin to creatinine (ACR) ratio of < 300 mg/g creatinine and ≥17 mg/g in men and ≥25 mg/g in women from a single-spot morning urine sample. Major changes on ECG were coded in duplicate using Minnesota classification. Results. The mean age of subjects was 51.5 (10.7) years. The median (25–75 percentile) ACR was 4.2 (2.9–7.9) mg/g in men and 6.0 (3.9–10.8) mg/g in women (P < 0.001). The overall prevalence (95% CI) of MA was 12.3% (11.1–13.5%), and 20.3% in those with major ECG changes. In a multivariable model, major ECG changes (OR, 95% CI) (1.50, 1.10–2.00), diabetes (3.57, 2.93–4.35), hypertension (2.30, 1.85–2.86), female sex (0.61, 0.53–0.69), age (1.09, 1.05–1.13, for each 5-year increase) and eGFR (0.80, 0.78–0.81, for each 10 mg/g increase) were independently associated with MA. The presence of MA increased the prevalence of major ECG changes from 21 to 31% in those with hypertension (44.9%), 15 to 28% among those with diabetes (21.4%), 14 to 26% among those with overweight or obesity (68.4%) and 14 to 26% among current users of tobacco (38.7%) (P < 0.001) each. Conclusions. The strong association between MA and major ECG changes underscores the importance of screening Indo-Asian subjects for MA for unmasking underlying CVD, especially those with hypertension, diabetes, obesity, and tobacco users.
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spelling pubmed-26980932009-06-19 Prevalence of microalbuminuria and associated electrocardiographic abnormalities in an Indo-Asian population Jafar, Tazeen H. Qadri, Zeeshan Hashmi, Shiraz Nephrol Dial Transplant Clinical Nephrology Background. Microalbuminuria (MA) is a known predictor of cardiovascular disease (CVD) in European origin populations, but such data are lacking in native Indo-Asian populations, where CVD risks are high. Major electrocardiographic (ECG) changes are predictive of cardiovascular mortality. We determined the association of MA with major ECG changes in the general population of Pakistan. Methods. A total of 3143 subjects aged ≥40 years from 12 randomly selected communities in Karachi participated. MA was defined as the urine albumin to creatinine (ACR) ratio of < 300 mg/g creatinine and ≥17 mg/g in men and ≥25 mg/g in women from a single-spot morning urine sample. Major changes on ECG were coded in duplicate using Minnesota classification. Results. The mean age of subjects was 51.5 (10.7) years. The median (25–75 percentile) ACR was 4.2 (2.9–7.9) mg/g in men and 6.0 (3.9–10.8) mg/g in women (P < 0.001). The overall prevalence (95% CI) of MA was 12.3% (11.1–13.5%), and 20.3% in those with major ECG changes. In a multivariable model, major ECG changes (OR, 95% CI) (1.50, 1.10–2.00), diabetes (3.57, 2.93–4.35), hypertension (2.30, 1.85–2.86), female sex (0.61, 0.53–0.69), age (1.09, 1.05–1.13, for each 5-year increase) and eGFR (0.80, 0.78–0.81, for each 10 mg/g increase) were independently associated with MA. The presence of MA increased the prevalence of major ECG changes from 21 to 31% in those with hypertension (44.9%), 15 to 28% among those with diabetes (21.4%), 14 to 26% among those with overweight or obesity (68.4%) and 14 to 26% among current users of tobacco (38.7%) (P < 0.001) each. Conclusions. The strong association between MA and major ECG changes underscores the importance of screening Indo-Asian subjects for MA for unmasking underlying CVD, especially those with hypertension, diabetes, obesity, and tobacco users. Oxford University Press 2009-07 2009-02-18 /pmc/articles/PMC2698093/ /pubmed/19225011 http://dx.doi.org/10.1093/ndt/gfp042 Text en © The Author [2009]. http://creativecommons.org/licenses/by-nc/2.0/uk/ The online version of this article has been published under an open access model. Users are entitled to use, reproduce, disseminate, or display the open access version of this article for non-commercial purposes provided that: the original authorship is properly and fully attributed; the Journal and Oxford University Press are attributed as the original place of publication with the correct citation details given; if an article is subsequently reproduced or disseminated not in its entirety but only in part or as a derivative work this must be clearly indicated. For commercial re-use, please contact journals.permissions@oxfordjournals.org
spellingShingle Clinical Nephrology
Jafar, Tazeen H.
Qadri, Zeeshan
Hashmi, Shiraz
Prevalence of microalbuminuria and associated electrocardiographic abnormalities in an Indo-Asian population
title Prevalence of microalbuminuria and associated electrocardiographic abnormalities in an Indo-Asian population
title_full Prevalence of microalbuminuria and associated electrocardiographic abnormalities in an Indo-Asian population
title_fullStr Prevalence of microalbuminuria and associated electrocardiographic abnormalities in an Indo-Asian population
title_full_unstemmed Prevalence of microalbuminuria and associated electrocardiographic abnormalities in an Indo-Asian population
title_short Prevalence of microalbuminuria and associated electrocardiographic abnormalities in an Indo-Asian population
title_sort prevalence of microalbuminuria and associated electrocardiographic abnormalities in an indo-asian population
topic Clinical Nephrology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2698093/
https://www.ncbi.nlm.nih.gov/pubmed/19225011
http://dx.doi.org/10.1093/ndt/gfp042
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