Johannes F.E. Mann, MD; Hertzel C. Gerstein, MD; Janice Pogue, MSc; Jackie Bosch, MA; Salim Yusuf, MD; HOPE Investigators
Grant Support: By the Medical Research Council of Canada, the Ontario Heart Foundation, Aventis, Astra-Zeneca, NEGMA, and the Natural Source Vitamin E Producers Association.
Requests for Single Reprints: Jackie Bosch, MA, HOPE Office, McMaster University, Hamilton General Hospital, 527 Barton Street East, Hamilton, Ontario L8L 2X2, Canada.
Current Author Addresses: Dr. Mann: Department of Nephrology and Hypertension, Schwabing General Hospital, LMU, Kolner Platz 1, D-80804 Munchen, Germany.
Drs. Gerstein, Pogue, and Yusuf and Ms. Bosch: HOPE Office, McMaster University, Hamilton General Hospital, 237 Barton Street East, Hamilton, Ontario L8L 2X2, Canada.
Author Contributions: Conception and design: J.F.E. Mann, H.C. Gerstein, S. Yusuf.
Analysis and interpretation of the data: J.F.E. Mann, H.C. Gerstein, J. Pogue.
Drafting of the article: J.F.E. Mann, H.C. Gerstein, S. Yusuf.
Critical revision of the article for important intellectual content: J.F.E. Mann, H.C. Gerstein, J. Pogue, J. Bosch, S. Yusuf.
Final approval of the article: J.F.E. Mann, H.C. Gerstein, J. Bosch, S. Yusuf.
Provision of study materials or patients: J.F.E. Mann, H.C. Gerstein, J. Bosch.
Statistical expertise: J. Pogue.
Obtaining of funding: H.C. Gerstein, S. Yusuf.
Collection and assembly of data: J.F.E. Mann, J. Bosch.
Mann JF, Gerstein HC, Pogue J, Bosch J, Yusuf S, . Renal Insufficiency as a Predictor of Cardiovascular Outcomes and the Impact of Ramipril: The HOPE Randomized Trial. Ann Intern Med. 2001;134:629-636. doi: 10.7326/0003-4819-134-8-200104170-00007
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Published: Ann Intern Med. 2001;134(8):629-636.
The future rate of cardiovascular events can be predicted by several well-established risk factors. Even in the absence of classic risk factors, patients with renal disease have an elevated risk for cardiovascular disease (1, 2). This renal–cardiovascular association is well established in patients with advanced renal insufficiency (2). It has also been reported in patients in the Hypertension Detection and Follow-up Program (HDFP) (3), in which a serum creatinine concentration greater than 133 µmol/L (1.5 mg/dL) was a strong predictor of cardiovascular disease. However, HDFP included only patients with hypertension. In contrast, a recent analysis of data from the Framingham Study did not detect a relationship between mild renal insufficiency (defined as a serum creatinine concentration of 124 to 265 µmol/L [1.4 to 3.0 mg/dL]) and cardiovascular events (4).
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Cardiology, Nephrology, Hypertension, Coronary Risk Factors.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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