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Risk Stratification...
Risk Stratification by 24-Hour Ambulatory Blood Pressure and Estimated Glomerular Filtration Rate in 5322 Subjects From 11 Populations
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Boggia, Jose (author)
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Thijs, Lutgarde (author)
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Li, Yan (author)
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Hansen, Tine W. (author)
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Kikuya, Masahiro (author)
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- Bjorklund-Bodegard, Kristina (author)
- Uppsala universitet,Geriatrik
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Ohkubo, Takayoshi (author)
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Jeppesen, Jorgen (author)
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Torp-Pedersen, Christian (author)
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Dolan, Eamon (author)
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Kuznetsova, Tatiana (author)
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Stolarz-Skrzypek, Katarzyna (author)
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Tikhonoff, Valerie (author)
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Malyutina, Sofia (author)
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Casiglia, Edoardo (author)
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Nikitin, Yuri (author)
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- Lind, Lars (author)
- Uppsala universitet,Kardiovaskulär epidemiologi
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Schwedt, Emma (author)
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Sandoya, Edgardo (author)
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Kawecka-Jaszcz, Kalina (author)
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Filipovsky, Jan (author)
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Imai, Yutaka (author)
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Wang, Jiguang (author)
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Ibsen, Hans (author)
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O'Brien, Eoin (author)
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Staessen, Jan A. (author)
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(creator_code:org_t)
- 2013
- 2013
- English.
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In: Hypertension. - 0194-911X .- 1524-4563. ; 61:1, s. 18-
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- No previous study addressed whether in the general population estimated glomerular filtration rate (eGFR [Chronic Kidney Disease Epidemiology Collaboration formula]) adds to the prediction of cardiovascular outcome over and beyond ambulatory blood pressure. We recorded health outcomes in 5322 subjects (median age, 51.8 years; 43.1% women) randomly recruited from 11 populations, who had baseline measurements of 24-hour ambulatory blood pressure (ABP(24)) and eGFR. We computed hazard ratios using multivariable-adjusted Cox regression. Median follow-up was 9.3 years. In fully adjusted models, which included both ABP(24) and eGFR, ABP(24) predicted (P <= 0.008) both total (513 deaths) and cardiovascular (206) mortality; eGFR only predicted cardiovascular mortality (P=0.012). Furthermore, ABP(24) predicted (P <= 0.0056) fatal combined with nonfatal events as a result of all cardiovascular causes (555 events), cardiac disease (335 events), or stroke (218 events), whereas eGFR only predicted the composite cardiovascular end point and stroke (P <= 0.035). The interaction terms between ABP(24) and eGFR were all nonsignificant (P >= 0.082). For cardiovascular mortality, the composite cardiovascular end point, and stroke, ABP(24) added 0.35%, 1.17%, and 1.00% to the risk already explained by cohort, sex, age, body mass index, smoking and drinking, previous cardiovascular disease, diabetes mellitus, and antihypertensive drug treatment. Adding eGFR explained an additional 0.13%, 0.09%, and 0.14%, respectively. Sensitivity analyses stratified for ethnicity, sex, and the presence of hypertension or chronic kidney disease (eGFR <60mL/min per 1.73 m(2)) were confirmatory. In conclusion, in the general population, eGFR predicts fewer end points than ABP(24). Relative to ABP(24), eGFR is as an additive, not a multiplicative, risk factor and refines risk stratification 2-to14-fold less.
Keyword
- ambulatory blood pressure
- population science
- renal function
- cardiovascular risk factors
- epidemiology
Publication and Content Type
- ref (subject category)
- art (subject category)
Find in a library
To the university's database
- By the author/editor
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Boggia, Jose
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Thijs, Lutgarde
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Li, Yan
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Hansen, Tine W.
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Kikuya, Masahiro
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Bjorklund-Bodega ...
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show more...
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Ohkubo, Takayosh ...
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Jeppesen, Jorgen
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Torp-Pedersen, C ...
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Dolan, Eamon
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Kuznetsova, Tati ...
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Stolarz-Skrzypek ...
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Tikhonoff, Valer ...
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Malyutina, Sofia
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Casiglia, Edoard ...
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Nikitin, Yuri
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Lind, Lars
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Schwedt, Emma
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Sandoya, Edgardo
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Kawecka-Jaszcz, ...
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Filipovsky, Jan
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Imai, Yutaka
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Wang, Jiguang
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Ibsen, Hans
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O'Brien, Eoin
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Staessen, Jan A.
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show less...
- Articles in the publication
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Hypertension
- By the university
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Uppsala University