Abstract 17235: Physical Activity Reduces Cardiovascular Mortality in Albuminuria: The Strong Heart Study
Background: Prior studies have established that albuminuria is associated with increased cardiovascular (CV) mortality. While it is known that physical activity (PA) improves CV clinical outcomes, studies regarding the CV impact of PA in patients with albuminuria remain conflicting.
Hypothesis: In this study, we tested the hypothesis that increased PA results in lower CV mortality in patients with albuminuria.
Methods: We examined the association between PA, albuminuria, and CV mortality among 3,186 adults (mean age 56±8) without baseline clinical evidence of CV disease in phase I of Strong Heart Study (1989-1991), a longitudinal study of American Indians. Baseline urine albumin-to-creatinine ratio was obtained. PA was measured as METS-hours per week on a validated questionnaire. Regression models and Kaplan Meier analysis were used to investigate the relationship between high and low PA on CV mortality in patients with albuminuria (mg/g): normal (<30), microalbuminuria (30-300), and macroalbuminuria (>300).
Results: After 16 years of follow-up, we found that albuminuria was associated with increased risk of CV mortality (p <0.001). This finding persisted after adjustment for traditional CV risk factors and stage 5 chronic kidney disease (micro- vs. macroalbuminuria; odds ratio [OR], 95% confidence interval [CI]: 2.3 [1.5-3.7] vs. 4.0 [2.3-7.0]; p<0.001). Notably, high PA compared to low PA significantly reduced risk of CV mortality in patients with any albuminuria (OR: 3.4 [1.6-7.4] and 4.8 [2.1-10.8], p<0.001; Fig. 1A-B). Lastly, in patients with any albuminuria, high PA compared to low PA was associated with lower fibrinogen levels (p<0.001; Fig. 1C).
Conclusion: High PA reduces CV mortality in patients with albuminuria. Fibrinogen levels correlated positively with albuminuria and negatively with PA. This study identifies high PA as a modifier of CV outcomes among American Indians with albuminuria, possibly due to lowering of systemic inflammation.
Author Disclosures: Z. Almazooq: None. B. Salata: None. M. Roman: None. R.B. Devereux: None. P. Singh: None.
- © 2016 by American Heart Association, Inc.