Highlights
- •Higher eGFR even in the normal range is associated with lower incident CVD.
- •Whether this association is consistent across all ages and sexes is unknown.
- •Our findings are from a large population-based cohort without prior CVD.
- •An increase in eGFR in the normal range was associated with lower incident CVD.
- •This association was evident in both sexes and across all ages.
Abstract
Background
Worse renal function, even in the normal or mildly impaired range, is associated with
incident cardiovascular disease (CVD). Whether this association exists in both sexes
across all ages is not known.
Methods
A population based cohort of individuals >22 years with no prior CVD and with an eGFR
60–130 ml/min/1.73 m2. eGFR was calculated using the CKD-EPI formula. Incident CVD was defined as either
myocardial infarction, unstable angina pectoris, coronary revascularization, or cerebrovascular
event. Incident CVD was examined separately in men and women in 3 age-groups (young,
22–40 years; middle-aged, 41–60 years; and elderly, ≥61 years), during a median follow-up
of 96.0 months.
Results
Among 1,341,400 individuals (57% women, mean age 49.2 ± 16.6 years), men had more
incident CVD as compared to women (34,968 vs. 23,515 total incident CVD) in all age-groups
(0.6% vs. 0.2% in young; 6.2% vs. 2.0% in middle-aged; 13.4% vs. 8.4% in elderly,
respectively). After adjustment for CVD risk factors, an increment of 10 units in
eGFR was independently associated with a decrease of 5.4%, 3.4% and 5.4% in incident
CVD in young, middle-aged and elderly men (p < 0.001 for each) and a decrease of 6.3%,
3.4% and 6.8% in the same age-groups in women (p < 0.001 for each). There was no significant
age-sex interaction in the association between eGFR and incident CVD.
Conclusion
Although incident CVD differs in men and women, as well as in different age-groups,
a higher eGFR even in the normal or mildly impaired range is associated with lesser
incident CVD in men and women of all ages.
Keywords
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Article info
Publication history
Published online: May 15, 2018
Accepted:
May 9,
2018
Received in revised form:
April 12,
2018
Received:
December 6,
2017
Identification
Copyright
© 2018 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
