[Renal failure as a cardiovascular risk factor]

A substantial amount of recent data suggests that even mild renal impairment is associated with a high risk of cardiovascular disease and exposes to a high risk of cardiovascular mortality in the case of an acute cardiovascular event. This relationship is consistent in all ranges of age including elderly subjects aged 65 years or above. The mechanisms behind this "renal-cardiovascular" association are probably intricated and include the high prevalence of traditional risk factors and the underutilisation of cardiovascular therapeutics and interventions in this population. On the other hand renal vascular damage may reflect the degree of systemic vascular damage. Alike proteinuria and microalbuminuria, renal insufficiency is a major independent cardiovascular risk factor, of the same magnitude as that confered by diabetes or symptomatic coronary disease. The risk increases continuously as the estimated glomerular filtration rate decreases below 60 mL/min, concerning at least 7% of all subjects aged 60 to 69 years and 25% above 70 years. Validated strategies for lowering the cardiovascular risk should be implemented to improve the prognosis in this high-risk population.