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Predictors of cardi...
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Kjeldsen, Sverre EUniversity of Oslo, Ullevaal Hospital, Oslo, Norway
(author)
Predictors of cardiovascular events in patients with hypertension and left ventricular hypertrophy : the losartan inventervention for endpoint reduction in hypertension study
- Article/chapterEnglish2009
Publisher, publication year, extent ...
Numbers
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LIBRIS-ID:oai:DiVA.org:umu-38982
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https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-38982URI
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https://gup.ub.gu.se/publication/108922URI
Supplementary language notes
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
Notes
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Objective. We assessed readily available patient characteristics, including albuminuria (not included in traditional cardiovascular risk scores), as predictors of cardiovascular events in hypertension with left ventricular hypertrophy (LVH) and developed risk algorithms/scores for outcomes. Methods. The Losartan Intervention For Endpoint reduction in hypertension (LIFE) study compared effects of losartan-based versus atenolol-based therapy on cardiovascular events in 9193 patients with hypertension and LVH. Univariate and multivariate analyses identified baseline variables with significant impact on development of the primary composite endpoint (cardiovascular death, stroke and myocardial infarction) and its components. Multivariate analysis used a Cox regression model with stepwise selection process. Risk scores were developed from coefficients of risk factors from the multivariate analysis, validated internally using naïve and jack-knife procedures, checked for discrimination and calibration, and compared with Framingham coronary heart disease and other risk scores. Results. LIFE risk scores showed increasing endpoint rates with increasing quintile (first to fifth quintile, composite endpoint 2.8–26.7%, cardiovascular death 0.5–14.4%, stroke 1.2–11.3%, myocardial infarction 1.4–8.1%) and were confirmed with a jack-knife approach that adjusts for potentially optimistic bias. The Framingham coronary heart disease and other risk scores overestimated risk in lower risk patients and underestimated risk in higher risk patients, except for myocardial infarction. Conclusion. A number of patient characteristics predicted cardiovascular events in patients with hypertension and LVH. Risk scores developed from these patient characteristics, including albuminuria, strongly predicted outcomes and may improve risk assessment of patients with hypertension and LVH and planning of clinical trials.
Subject headings and genre
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Cardiovascular disease
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hypertension
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left ventricular hypertrophy
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risk factors
Added entries (persons, corporate bodies, meetings, titles ...)
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Devereux, Richard BWeill Cornell Medical College, New York, NY, USA
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Hille, Darcy AMerck Research Laboratories, North Wales, PA, USA
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Lyle, Paulette AMerck Research Laboratories, North Wales, PA, USA
(author)
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Dahlöf, Björn,1953Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för akut och kardiovaskulär medicin,Institute of Medicine, Department of Emergeny and Cardiovascular Medicine(Swepub:gu)xdahbj
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Julius, StevoUniversity of Michigan Medical Center, Ann Arbor, MI, USA
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Edelman, Jonathan MMerck Research Laboratories, North Wales, PA, USA
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Snapinn, Steven MMerck Research Laboratories, North Wales, PA, USA
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de Faire, UlfKarolinska University Hospital, Stockholm, Sweden
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Fyhrquist, FrejHelsinki University Central Hospital, Helsinki, Finland
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Ibsen, HansHolbaek Hospital, Holbaek, Denmark
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Lederballe-Pedersen, OleViborg Hospital, Viborg, Denmark
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Lindholm, Lars HUmeå universitet,Allmänmedicin(Swepub:umu)lali0003
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Nieminen, Markku SHelsinki University Central Hospital, Helsinki, Finland
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Omvik, PerHaukeland University Hospital, Bergen, Norway
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Oparil, SuzanneUniversity of Alabama Medical Center, Birmingham, AL, USA
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Wedel, HansNordic School of Public Health, Göteborg, Sweden
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University of Oslo, Ullevaal Hospital, Oslo, NorwayWeill Cornell Medical College, New York, NY, USA
(creator_code:org_t)
Related titles
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In:Blood Pressure18:6, s. 348-3610803-70511651-1999
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Hille, Darcy A
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Lyle, Paulette A
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Julius, Stevo
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Lindholm, Lars H
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Omvik, Per
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