August 12, 2026Journal of the American College of CardiologyOpen Access

Level of kidney function as a risk factor for atherosclerotic cardiovascular outcomes in the community

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Atherosclerotic cardiovascular disease (n=15350). Intervention: Glomerular filtration rate (GFR) 15 to 59 ml/min/1.73 m2 vs. GFR of 90 to 150 ml/min/1.73 m2. Primary outcome: Atherosclerotic cardiovascular disease (ASCVD) (HR 1.38, 95% CI 1.02, 1.87).

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Key result

Lower GFR is linked to ~38% higher ASCVD risk compared to normal kidney function.

HR 1.38
95% CI 1.02, 1.87
n=15,350

Why the study?

Does lower glomerular filtration rate increase the risk of atherosclerotic cardiovascular disease in a community-based cohort?

Population

15,350 subjects aged 45 to 64 years from the Atherosclerosis Risk in Communities (ARIC) study

Comparison

Lower glomerular filtration rate (GFR) vs GFR of 90 to 150 ml/min/1.73 m(2)

Design

Cohort

Follow-up

mean 6.2 years

Authors

GMGuruprasad ManjunathTufts University HTHocine TighiouartHeart Failure & Transplant HIHassan N. IbrahimAllied Hospital

Discussion

Member takes

Implication

Lower glomerular filtration rate is an independent risk factor for atherosclerotic cardiovascular disease in the general community.

Key Points

To determine whether kidney function, quantified by glomerular filtration rate, is an independent risk factor for atherosclerotic cardiovascular disease outcomes in a general community cohort.
Prospective cohort study analyzing 15,350 participants aged 45 to 64 years from the Atherosclerosis Risk in Communities (ARIC) study with a mean follow-up of 6.2 years.
Multivariable Cox proportional-hazards regression was used to evaluate linear and nonlinear associations between glomerular filtration rate (GFR) and atherosclerotic cardiovascular disease (ASCVD) adjusting for major cardiovascular risk factors.
During follow-up, 965 participants (6.3%) experienced an ASCVD event.
Compared to subjects with GFR 90 to 150 ml/min/1.73 m², adjusted hazard ratios were 1.16 (95% CI, 1.00–1.34) for GFR 60 to 89 ml/min/1.73 m² and 1.38 (95% CI, 1.02–1.87) for GFR 15 to 59 ml/min/1.73 m².
Each 10 ml/min/1.73 m² lower GFR was associated with an adjusted HR of 1.05 (95% CI, 1.02–1.09) for overall ASCVD, 1.07 (95% CI, 1.01–1.12) for de novo ASCVD, and 1.06 (95% CI, 0.99–1.13) for recurrent ASCVD.

Study Design

Type

Cohort (n=15,350)

Structured PICO

Does lower glomerular filtration rate increase the risk of atherosclerotic cardiovascular disease in a community-based cohort?

Population

15,350 community-dwelling subjects aged 45 to 64 years followed for a mean of 6.2 years to evaluate the association between glomerular filtration rate and ASCVD.

Exposure

Lower glomerular filtration rate (GFR)

Comparator

GFR of 90 to 150 ml/min/1.73 m(2)

Outcome

Atherosclerotic cardiovascular disease (ASCVD) outcomeshard clinical

Main Result

Hazard Ratio: 1.38 (95% CI 1.02–1.87)

Lower glomerular filtration rate is an independent risk factor for atherosclerotic cardiovascular disease in the general community.

Cite This Study

Manjunath et al. (2002) conducted a cohort in Atherosclerotic cardiovascular disease (n=15,350). Glomerular filtration rate (GFR) 15 to 59 ml/min/1.73 m2 vs. GFR of 90 to 150 ml/min/1.73 m2 was evaluated on Atherosclerotic cardiovascular disease (ASCVD) (HR 1.38, 95% CI 1.02, 1.87). A GFR of 15 to 59 ml/min/1.73 m2 was associated with an increased risk of ASCVD compared with a GFR of 90 to 150 ml/min/1.73 m2 (HR 1.38; 95% CI 1.02-1.87).

synapsesocial.com/papers/6a7ce341939ceeb56f39b97c https://doi.org/10.1016/s0735-1097(02)02663-3

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