Related Experiment Videos

Microalbuminuria and cardiovascular autonomic dysfunction are independently associated with cardiovascular mortality:

Hanneke J B H Beijers1, Isabel Ferreira, Bert Bravenboer

  • 1Department of Internal Medicine, Catharina Hospital, Eindhoven, the Netherlands.

Diabetes Care
|July 1, 2009
PubMed
Abstract

Insights

Microalbuminuria and cardiovascular autonomic dysfunction (C-AD) are independent predictors of cardiovascular mortality. C-AD does not explain the increased mortality risk associated with microalbuminuria in older adults.

Area of Science:

  • Cardiology
  • Nephrology
  • Endocrinology

Background:

  • Microalbuminuria is linked to increased cardiovascular mortality, especially in type 2 diabetes patients.
  • Cardiovascular autonomic dysfunction (C-AD) is also associated with higher cardiovascular mortality.
  • The relationship between microalbuminuria, C-AD, and cardiovascular mortality requires further investigation.

Purpose of the Study:

  • To determine if C-AD mediates the association between microalbuminuria and cardiovascular mortality.
  • To investigate the independent contributions of microalbuminuria and C-AD to cardiovascular mortality risk.

Main Methods:

  • A population-based cohort of 490 individuals aged 50-75 years was followed for a median of 13.6 years.
  • Microalbuminuria was defined by albumin-to-creatinine ratio (> or =2.0 mg/mmol).
  • Cardiovascular autonomic dysfunction (C-AD) was assessed using ten parameters compiled into a total score; associations were analyzed using regression and Cox proportional hazards models.

Main Results:

  • Adjusted analyses revealed C-AD was associated with microalbuminuria (beta = 0.16).
  • Both microalbuminuria (RR 2.09) and C-AD (RR 1.74) were significantly associated with cardiovascular mortality.
  • These associations remained significant after mutual adjustment, indicating independent effects.

Conclusions:

  • Microalbuminuria and C-AD are independent risk factors for cardiovascular mortality.
  • C-AD does not explain the excess cardiovascular mortality associated with microalbuminuria.
  • Both conditions warrant attention for cardiovascular risk assessment.

Related Concept Videos

Diabetic Nephropathy01:28

Diabetic Nephropathy

Definition Diabetic nephropathy is a chronic kidney complication that results from prolonged hyperglycemia.Prevalence It is the most common cause of chronic kidney disease (CKD) and end-stage renal disease (ESRD) worldwide, affecting up to half of individuals with diabetes.Pathophysiology • Sustained hyperglycemia triggers multiple hemodynamic and metabolic changes in the kidney. • Early in the disease, increased renal blood flow and glomerular hyperfiltration occur due to afferent arteriolar...
Coronary Artery Disease I: Introduction01:30

Coronary Artery Disease I: Introduction

Coronary Artery Disease (CAD): An Overview with Scientific InsightsCoronary Artery Disease (CAD), often referred to as C-A-D, is a prevalent blood vessel disorder classified under the broader category of atherosclerosis. Atherosclerosis is a pathological process characterized by the hardening and narrowing of arteries due to the accumulation of atherosclerotic plaques. These plaques are composed of cholesterol, fatty substances, inflammatory cells, calcium, and fibrin, reducing blood flow to...
Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers01:19

Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers

Cardiac biomarkers are critical in diagnosing, prognosing, and managing cardiovascular diseases. Routine measurement of specific biomarkers such as B-type natriuretic peptide (BNP), C-reactive protein (CRP), and homocysteine (Hcy) is common practice in clinical settings to evaluate heart function and predict cardiovascular events.
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
Pathophysiology of Heart Failure01:17

Pathophysiology of Heart Failure

Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
Hypertension II: Pathophysiology01:29

Hypertension II: Pathophysiology

Hypertension is a chronic condition in which the blood's force against artery walls is excessively high, posing risks such as heart disease. The condition's underlying mechanisms involve complex interactions among the cardiovascular, kidney, and autonomic nervous systems.Renin-Angiotensin-Aldosterone System (RAAS): This system significantly influences blood pressure regulation. When blood pressure decreases, the kidneys secrete renin. This enzyme transforms angiotensinogen, a plasma protein,...
Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...