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Renovascular disease and the risk of adverse coronary events in the elderly: a prospective, population-based study

Matthew S Edwards1, Timothy E Craven, Gregory L Burke

  • 1Section on Vascular Surgery, Division of Surgical Sciences, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1095, USA.

Archives of Internal Medicine
|January 26, 2005
PubMed

Insights

Renovascular disease, a condition affecting kidney arteries, significantly increases the risk of adverse coronary events in elderly Americans. This risk is independent of other cardiovascular disease factors and high blood pressure.

Area of Science:

  • Cardiovascular Medicine
  • Nephrology
  • Geriatrics

Background:

  • Renovascular disease is a known cause of secondary hypertension and renal insufficiency.
  • It is suspected to contribute to the morbidity and mortality associated with coronary heart disease.
  • This study investigates the link between renovascular disease and adverse coronary events in elderly Americans.

Purpose of the Study:

  • To prospectively examine the association between renovascular disease and adverse coronary events.
  • To determine if this association is independent of other cardiovascular risk factors and blood pressure.

Main Methods:

  • Prospective, multicenter cohort study (Cardiovascular Health Study) of individuals over 65 years.
  • Renal duplex sonography used to identify renovascular disease (renal artery stenosis or occlusion).
  • Adverse coronary events defined as hospitalized angina, myocardial infarction, or coronary revascularization.

Main Results:

  • Renovascular disease was significantly associated with an increased risk of adverse coronary events (HR, 1.96; 95% CI, 1.00-3.83; P = .05).
  • This association remained significant after controlling for atherosclerotic risk factors and prevalent cardiovascular disease.
  • The relationship was not dependent on elevated blood pressure.

Conclusions:

  • Presence of renovascular disease is linked to a higher risk of adverse coronary events in the elderly population studied.
  • This increased risk is not explained by coexisting atherosclerotic risk factors, other cardiovascular diseases, or hypertension.
  • Renovascular disease represents an independent risk factor for coronary events in older adults.
Abstract

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