What question did this study set out to answer?

To determine whether the relationship between albuminuria and cardiovascular risk can predict cardiovascular morbidity and mortality in hypertensive patients.

December 2, 2003Annals of Internal Medicine

Albuminuria and Cardiovascular Risk in Hypertensive Patients with Left Ventricular Hypertrophy: The LIFE Study

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Why the study?

Does increased urine albumin-creatinine ratio predict cardiovascular morbidity and mortality in hypertensive patients with left ventricular hypertrophy?

Population

8,206 patients with stage II or III hypertension and left ventricular hypertrophy

Design

Cohort, randomly assigned to therapy with losartan or atenolol, double-blind

Follow-up

39 122 patient-years

Authors

KWKristian WachtellInterventional Cardiology

Discussion

Member takes

Implication

UACR continuously signals higher CV risk without threshold in nondiabetic hypertensives with LVH; extends prior observations but leaves open therapeutic implications.

Key Points

To determine whether the relationship between albuminuria and cardiovascular risk can predict cardiovascular morbidity and mortality in hypertensive patients.
Multicenter study evaluating 8,206 patients with stage II or III hypertension and left ventricular hypertrophy randomly assigned to double-blind therapy with losartan or atenolol over 39,122 patient-years of follow-up.
Renal glomerular permeability was evaluated using the urine albumin-creatinine ratio (UACR).
Risk for the composite cardiovascular endpoint increased continuously with increasing UACR in nondiabetic patients with no specific threshold or plateau (P < 0.001 for trend).
For every 10-fold increase in UACR in nondiabetic patients, hazard ratios increased for the composite cardiovascular endpoint by 57% (95% CI, 40.6% to 75.0%), cardiovascular mortality by 97.7% (95% CI, 66.5% to 235%), all-cause mortality by 75.2% (95% CI, 54.0% to 99.4%), stroke by 51.0% (95% CI, 28.8% to 76.9%), and myocardial infarction by 45% (95% CI, 19.9% to 75.4%) (P < 0.001 for all).

Structured PICO

Does increased urine albumin-creatinine ratio predict cardiovascular morbidity and mortality in hypertensive patients with left ventricular hypertrophy?

Population

8,206 patients with stage II or III hypertension and left ventricular hypertrophy

Intervention

Urine albumin-creatinine ratio (UACR) evaluation

Outcome

Composite cardiovascular end pointcomposite

Increased urine albumin-creatinine ratio is continuously associated with higher cardiovascular risk in hypertensive patients with left ventricular hypertrophy, with no specific threshold.

Cite This Study

Kristian Wachtell (2003) studied this question.

synapsesocial.com/papers/6a7cffbfc9ada5f6b9d59ccd https://doi.org/10.7326/0003-4819-139-11-200312020-00008

Topics

Hypertension management Women and heart disease

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Implication

UACR continuously signals higher CV risk without threshold in nondiabetic hypertensives with LVH; extends prior observations but leaves open therapeutic implications.

Albuminuria and Cardiovascular Risk in Hypertensive Patients with Left Ventricular Hypertrophy: The LIFE Study

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Albuminuria and Cardiovascular Risk in Hypertensive Patients with Left Ventricular Hypertrophy: The LIFE Study

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

Also Consider