Abstract MP071: A Healthy Cardiovascular Risk Factor Profile is Associated With Lower Incidence of End-stage Renal Disease Among US Adults With Chronic Kidney Disease
The American Heart Association’s (AHA) Life’s Simple 7 measure of cardiovascular health includes biological and behavioral factors (cigarette smoking, physical activity, diet, body mass index, blood pressure, cholesterol, and glucose). We determined the association of health factors in the AHA Life’s Simple 7 metric with end-stage renal disease (ESRD) incidence among participants with chronic kidney disease (CKD; estimated glomerular filtration rate < 60 ml/min/1.73 m2) from the population-based REasons for Geographic and Racial Differences in Stroke (REGARDS) study (n=30,239). Each of the AHA Life’s Simple 7 components was assessed at baseline and categorized as poor (1 point), intermediate (2 points) or ideal (3 points). At baseline, 3,093 participants had CKD. The mean age of the study sample was 72.2 years, 42% were African American and 45% were men. Amongst this group, 162 participants developed ESRD over a median 4 years of follow-up. For each Life’s Simple 7 component except cholesterol, a graded association was present with a lower incidence of ESRD among participants with better health factor levels. After adjustment for age, race, sex, geographic region of residence, income, and education and compared to individuals with 0 or 1 ideal health factors, the hazard ratios for ESRD among those with 2, 3, and 4 ideal health factors were 0.62 (95% CI: 0.43 - 0.89), 0.54 (95% CI: 0.35 - 0.83), and 0.46 (95% CI: 0.24 - 0.88), respectively. No cases of ESRD occurred among participants with 5-7 ideal health factors. On a scale from 7 (all 7 factors poor) to 21 (all 7 factors ideal), each one point higher Life’s Simple 7 score was associated with a 22% lower ESRD risk (hazard ratio 0.78; 95% CI: 0.72 - 0.85). When biologic and behavioral health factors were evaluated separately, similar patterns of lower ESRD risk with better risk factor profiles were present. In the current study, a strong, graded association was present between a better cardiovascular risk factor profile and lower ESRD risk.
- © 2012 by American Heart Association, Inc.