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Association between normal or mildly reduced kidney function, cardiovascular risk and biomarkers for atherosclerosis: results from the ENCORE trial

BACKGROUND: Moderate-to-severe kidney dysfunction is associated with atherosclerotic cardiovascular disease (ASCVD). Gradations of normal or mildly reduced kidney function may also associate with ASCVD risk. METHODS: We conducted a secondary analysis using baseline data from the Exercise and Nutriti...

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Autores principales: Tyson, Crystal C., Smith, Patrick J., Sherwood, Andrew, Mabe, Stephanie, Hinderliter, Alan L., Blumenthal, James A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5622906/
https://www.ncbi.nlm.nih.gov/pubmed/28979778
http://dx.doi.org/10.1093/ckj/sfx025
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author Tyson, Crystal C.
Smith, Patrick J.
Sherwood, Andrew
Mabe, Stephanie
Hinderliter, Alan L.
Blumenthal, James A.
author_facet Tyson, Crystal C.
Smith, Patrick J.
Sherwood, Andrew
Mabe, Stephanie
Hinderliter, Alan L.
Blumenthal, James A.
author_sort Tyson, Crystal C.
collection PubMed
description BACKGROUND: Moderate-to-severe kidney dysfunction is associated with atherosclerotic cardiovascular disease (ASCVD). Gradations of normal or mildly reduced kidney function may also associate with ASCVD risk. METHODS: We conducted a secondary analysis using baseline data from the Exercise and Nutritional Interventions for Cardiovascular Health (ENCORE) trial. Participants were sedentary, overweight and obese adults with unmedicated pre-hypertension or Stage I hypertension and an estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m(2). The Pooled Cohorts Equations were used to estimate a 10-year risk for first ASCVD event. Carotid artery intima-media thickness (IMT) and brachial artery flow-mediated dilation (FMD) were measured to assess subclinical atherosclerosis and vascular endothelial function, respectively. Using linear regression, we examined the association between eGFR and ASCVD risk, IMT and FMD. RESULTS: Participants (N = 139) were predominantly women (65%), white (60%), with a mean age of 52.0 ± 9.6 years and mean eGFR of 89.1 ± 15.0 mL/min/1.73 m(2). Lower eGFR of 15 mL/min/1.73 m(2) was associated with higher ASCVD risk [b = −2.7% (95% confidence interval: −3.7, −1.8%), P < 0.001], higher IMT [b = 0.05 mm (0.03, 0.08 mm), P < 0.001] and lower FMD [b = −0.87% (−1.64, −0.11%), P = 0.026]. Compared with eGFR ≥90 mL/min/1.73 m(2), those with eGFR 60–89 mL/min/1.73 m(2) had higher mean ASCVD risk (7.6% versus 2.7%; P < 0.001), greater mean IMT (0.74 mm versus 0.66 mm; P < 0.001) and lower mean FMD (2.0% versus 3.7%; P = 0.026). After controlling for CVD risk factors, the association between eGFR and IMT remained significant (P < 0.001), and eGFR and FMD trended toward significance (P = 0.08). CONCLUSIONS: Among overweight and obese adults with unmedicated high blood pressure and eGFR ≥60 mL/min/1.73 m(2), lower eGFR is associated with a greater 10-year risk for first ASCVD event, higher IMT and relatively impaired FMD.
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spelling pubmed-56229062017-10-04 Association between normal or mildly reduced kidney function, cardiovascular risk and biomarkers for atherosclerosis: results from the ENCORE trial Tyson, Crystal C. Smith, Patrick J. Sherwood, Andrew Mabe, Stephanie Hinderliter, Alan L. Blumenthal, James A. Clin Kidney J Cardiovascular Risk BACKGROUND: Moderate-to-severe kidney dysfunction is associated with atherosclerotic cardiovascular disease (ASCVD). Gradations of normal or mildly reduced kidney function may also associate with ASCVD risk. METHODS: We conducted a secondary analysis using baseline data from the Exercise and Nutritional Interventions for Cardiovascular Health (ENCORE) trial. Participants were sedentary, overweight and obese adults with unmedicated pre-hypertension or Stage I hypertension and an estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m(2). The Pooled Cohorts Equations were used to estimate a 10-year risk for first ASCVD event. Carotid artery intima-media thickness (IMT) and brachial artery flow-mediated dilation (FMD) were measured to assess subclinical atherosclerosis and vascular endothelial function, respectively. Using linear regression, we examined the association between eGFR and ASCVD risk, IMT and FMD. RESULTS: Participants (N = 139) were predominantly women (65%), white (60%), with a mean age of 52.0 ± 9.6 years and mean eGFR of 89.1 ± 15.0 mL/min/1.73 m(2). Lower eGFR of 15 mL/min/1.73 m(2) was associated with higher ASCVD risk [b = −2.7% (95% confidence interval: −3.7, −1.8%), P < 0.001], higher IMT [b = 0.05 mm (0.03, 0.08 mm), P < 0.001] and lower FMD [b = −0.87% (−1.64, −0.11%), P = 0.026]. Compared with eGFR ≥90 mL/min/1.73 m(2), those with eGFR 60–89 mL/min/1.73 m(2) had higher mean ASCVD risk (7.6% versus 2.7%; P < 0.001), greater mean IMT (0.74 mm versus 0.66 mm; P < 0.001) and lower mean FMD (2.0% versus 3.7%; P = 0.026). After controlling for CVD risk factors, the association between eGFR and IMT remained significant (P < 0.001), and eGFR and FMD trended toward significance (P = 0.08). CONCLUSIONS: Among overweight and obese adults with unmedicated high blood pressure and eGFR ≥60 mL/min/1.73 m(2), lower eGFR is associated with a greater 10-year risk for first ASCVD event, higher IMT and relatively impaired FMD. Oxford University Press 2017-10 2017-05-02 /pmc/articles/PMC5622906/ /pubmed/28979778 http://dx.doi.org/10.1093/ckj/sfx025 Text en © The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Cardiovascular Risk
Tyson, Crystal C.
Smith, Patrick J.
Sherwood, Andrew
Mabe, Stephanie
Hinderliter, Alan L.
Blumenthal, James A.
Association between normal or mildly reduced kidney function, cardiovascular risk and biomarkers for atherosclerosis: results from the ENCORE trial
title Association between normal or mildly reduced kidney function, cardiovascular risk and biomarkers for atherosclerosis: results from the ENCORE trial
title_full Association between normal or mildly reduced kidney function, cardiovascular risk and biomarkers for atherosclerosis: results from the ENCORE trial
title_fullStr Association between normal or mildly reduced kidney function, cardiovascular risk and biomarkers for atherosclerosis: results from the ENCORE trial
title_full_unstemmed Association between normal or mildly reduced kidney function, cardiovascular risk and biomarkers for atherosclerosis: results from the ENCORE trial
title_short Association between normal or mildly reduced kidney function, cardiovascular risk and biomarkers for atherosclerosis: results from the ENCORE trial
title_sort association between normal or mildly reduced kidney function, cardiovascular risk and biomarkers for atherosclerosis: results from the encore trial
topic Cardiovascular Risk
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5622906/
https://www.ncbi.nlm.nih.gov/pubmed/28979778
http://dx.doi.org/10.1093/ckj/sfx025
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