Kidney function and risk of cardiovascular disease and mortality in women: a prospective cohort study

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Kidney function and risk of cardiovascular disease and mortality in women: a prospective cohort study

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dc.contributor.author de Jong, Paul E
dc.contributor.author Kurth, Tobias
dc.contributor.author Cook, Nancy Romanowicz
dc.contributor.author Buring, Julie Elizabeth
dc.contributor.author Ridker, Paul M.
dc.date.accessioned 2011-05-10T00:11:49Z
dc.date.issued 2009
dc.identifier.citation Kurth, Tobias, Paul E. de Jong, Nancy R. Cook, Julie E. Buring, and Paul M. Ridker. 2009. Kidney function and risk of cardiovascular disease and mortality in women: a prospective cohort study. British Medical Journal 338: b2392. en_US
dc.identifier.issn 0959-8138 en_US
dc.identifier.uri http://nrs.harvard.edu/urn-3:HUL.InstRepos:4885948
dc.description.abstract Objective: To evaluate the association of kidney function with cardiovascular disease and mortality among apparently healthy women. Design: Prospective cohort study. Setting: Women’s Health Study, United States. Participants: 27 939 female health professionals aged ≥45 who were free of cardiovascular disease and other major disease and who provided a blood sample at study entry. Main outcome measures: Time to cardiovascular disease (non-fatal stroke, non-fatal myocardial infarction, coronary revascularisation procedures, or death from cardiovascular cause), specific cardiovascular disease events, and all-cause mortality. End points were confirmed after review of medical records and death certificates. Results: Glomerular filtration rate (GFR) was estimated with the abbreviated Modification of Diet in Renal Disease Study equation. At baseline, 1315 (4.7%) women had GFR <60 ml/min/1.73 m2. During 12 years of follow-up, 1199 incident cardiovascular disease events and 856 deaths (179 from cardiovascular disease) occurred. Compared with women with GFR ≥90 ml/min/1.73 m2, the multivariable adjusted hazard ratios for any first cardiovascular disease were 0.95 (95% CI 0.83 to 1.08), 0.84 (0.70 to 1.00), and 1.00 (0.79 to 1.27) among women with GFR of 75-89.9, 60-74.9, and <60 ml/min/1.73 m2, respectively; the equivalent hazard ratios for all cause mortality were 0.93 (0.79 to 1.09), 1.03 (0.85 to 1.26), and 1.09 (0.83 to 1.45). Similar null findings were observed for myocardial infarction, stroke, coronary revascularisation, and non-cardiovascular death. However, an increased risk of death from cardiovascular disease was found among women with GFR <60 ml/min/1.73 m2 (hazard ratio 1.68 (1.02 to 2.79)). Conclusions: In this large cohort of women, a glomerular filtration rate <60 ml/min/1.73 m2 was associated with increased risk of cardiovascular disease death but not other cardiovascular disease events or non-cardiovascular disease mortality. We observed no increase in risk of any of the outcomes among women with less severe impairment of kidney function. en_US
dc.language.iso en_US en_US
dc.publisher BMJ Publishing Group Ltd. en_US
dc.relation.isversionof doi:10.1136/bmj.b2392 en_US
dc.relation.hasversion http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2704981/pdf/ en_US
dash.license LAA
dc.subject epidemiologic studies en_US
dc.subject drugs: cardiovascular system en_US
dc.subject stroke en_US
dc.subject diet en_US
dc.subject ischaemic heart disease en_US
dc.subject fluid electrolyte and acid-base disturbances en_US
dc.title Kidney function and risk of cardiovascular disease and mortality in women: a prospective cohort study en_US
dc.type Journal Article en_US
dc.description.version Version of Record en_US
dc.relation.journal British Medical Journal en_US
dash.depositing.author Kurth, Tobias
dc.date.available 2011-05-10T00:11:49Z
dash.affiliation.other SPH^Epidemiology en_US
dash.affiliation.other HMS^Medicine-Brigham and Women's Hospital en_US
dash.affiliation.other SPH^Epidemiology en_US
dash.affiliation.other HMS^Medicine-Brigham and Women's Hospital en_US
dash.affiliation.other SPH^Epidemiology en_US
dash.affiliation.other HMS^Population Medicine en_US
dash.affiliation.other HMS^Medicine-Brigham and Women's Hospital en_US
dash.affiliation.other SPH^Biostatistics en_US
dash.affiliation.other SPH^Epidemiology en_US
dash.affiliation.other HMS^Medicine-Brigham and Women's Hospital en_US

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