Heart Care Info - Heart Disease Prevention & Treatment

A prospective study of albuminuria and incident coronary heart disease in Aboriginal people

Z Wang... - 40th Annual Scientific Meeting of the ..., 2011 - Aborigines have exceedingly high rates of renal failure together with increased cardiovascular mortality. We examined the relation between microand marcro-albuminuria and incident coronary heart disease (CHD) in a population of 871 Aboriginal adults aged 2074 years without ...

Australian Aborigines have exceedingly high rates of renal failure together with increased cardiovascular mortality. We examined the relation between microand marcro-albuminuria and incident coronary heart disease (CHD) in a population of 871 Aboriginal adults aged 20–74 years without prevalent baseline CHD, who were followed up to May 2003 from the baseline examination (1992–2005). At baseline, participants were categorised into normoalbuminuria, microalbuminuria, and macroalbuminuria groups. CHD events were identified from hospital and death records using the codes of the International Classification of Disease (ICD-9-CM codes 410–414 and ICD-10-AM code I20-I25). Only first CHD incidents (fatal or nonfatal) were included in this study. During a median of 8.7 years of follow-up, 87 new CHD events occurred during the followup period (1992–2003). The incidence of CHD increased significantly across categories of albuminuria (4.4, 13.2, and 32.6/1000 perso-years for normoalbuminuria, microalbuminuria and macroalbuminuria, respectively). The cumulative CHD incidences by albuminuria status are shown in Fig. 1. Rate ratios for CHD were 2.1 (95% confidence interval (CI: 1.1, 4.0) for microalbuminuria and 4.3 (95% CI: 2.4, 7.8) for macroalbuminuria, adjusting for age and sex using Cox proportional hazards method. With adjustment for age, sex, blood pressure, total cholesterol, diabetes status, cigarette smoke and alcohol consumption, rate ratios for CHD were 2.0 (95% CI: 1.0, 4.0) for microalbuminuria and 2.6 (95% CI: 1.3, 5.4) for macroalbuminuria. About 15% (95% CI 0, 29) CHD risk in the study population was attributable to microalbuminuria and 32% (95% CI: 7, 50) to macroalbuminuria. Independent of traditional cardiovascular risk factors, both microalbuminuria and macroalbuminuria are useful in identifying increased risk of CHD in Aboriginal people.