Cardiovascular morbidity and risk factors in renal transplant patients

Cardiovascular disease is now the major cause of death in renal transplant patients. This study aimed to assess the prevalence of cardiovascular disease in stable renal transplant patients as compared with the general background population, and to assess risk factors for cardiovascular disease in this patient group.

A cross-sectional multicentre study comprising 406 stable renal transplant patients (age 47+/-16 years, 60% males, 71% taking cyclosporin A) were assessed clinically and biochemically 48 months (median) after transplantation and compared with the general population. Multivariate analysis was used to assess the relation between cardiovascular disease and risk factors.

Hypertension was present in 55% of males and 34% of females (P<0.001), in 51% with cyclosporin A and in 33% without (P<0.001). Ischaemic heart disease (i.e. angina pectoris and/or previous myocardial infarction) was present in 14% (males: 18%, females: 10%, P<0.05) and in 24% of diabetics vs 12% of non-diabetics (P<0.01). Cerebro- and peripheral vascular disease was found in 3% and 4%, respectively. Odds ratio for angina pectoris (patients vs general population) was: in age group 40-49 years (males/females), 12/16; 50-59 years, 6/4; 60-69 years, 3/4. Ischaemic heart disease was, besides age and gender, independently associated with total cholesterol (P<0.01), and peripheral vascular disease to systolic blood pressure (P<0.01).

Cardiovascular disease is highly prevalent in renal transplant patients, and is independently associated with age, gender, total cholesterol and systolic blood pressure.