Abstract 18319: The Impact of Low Grade Urinary Albumin on the Risk of Cardiovascular Disease in the Nonhypertensive and Nondiabetic Population
Background: The guidelines recommend screening for microalbuminuria in patients with hypertension and diabetes. Recent cohort studies document a continuous association between low grade urinary albumin (UA) and increased risk of cardiovascular disease (CVD) in these patient groups. However, it is unclear whether this association is present in individuals without hypertension and diabetes.
Hypothesis: Even in the nonhypertensive and nondiabetic population, UA from low levels may be related to future CVD risk.
Methods: A population-based prospective cohort study was performed in 13,451 nonhypertensive, nondiabetic individuals aged 40 to 89 years (mean age = 60.4±10.2 years) with no cardiovascular history. A multivariate Cox regression analysis was performed to examine the relationship between quartile of urinary albumin/creatinine ratios (UACRs) and the incidence of CVD which was defined as stroke or acute myocardial infarction/sudden cardiac death.
Results: During a mean follow-up period of 5.6 years, 213 subjects developed CVD. Compared with the 1st UACR quartile (< 8.4 mg/g), the hazard ratios and 95% confidence intervals (CIs) for the incidence of CVD were 1.56 (1.04-2.32), 1.61 (1.07-2.42), 1.74 (1.13-2.68) in the 2nd (8.4-14.6 mg/g), the 3rd (14.7-29.4 mg/g), the 4th UACR quartile (> 29.4 mg/g) after adjustment for age, sex, body mass index, eGFR, total and HDL cholesterol, smoking habits, and systolic blood pressure. Furthermore, the population-attributable fraction of CVD incidence was 31.0 % for the 2nd to the 4th UACR quartiles.
Conclusions: Even in the nonhypertensive and nondiabetic population, UA from low levels is continuously related to future CVD risk and contributes to approximately one-third of excess CVD risk.
Author Disclosures: F. Tanaka: None. S. Makita: None. T. Onoda: None. K. Tanno: None. M. Ohsawa: None. K. Itai: None. K. Sakata: None. S. Omama: None. K. Ogasawara: None. Y. Ishibashi: None. A. Okayama: None. M. Nakamura: None.
- © 2014 by American Heart Association, Inc.