Kristian Wachtell, MD, PhD; Michael Hecht Olsen, MD, PhD; Hans Ibsen, MD
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Wachtell K., Olsen M., Ibsen H.; Albuminuria and Mortality in Hypertension. Ann Intern Med. 2004;141:245. doi: 10.7326/0003-4819-141-3-200408030-00025
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Published: Ann Intern Med. 2004;141(3):245.
When hazard ratios are adjusted for risk factors as in Tables 1 and 2 in our paper, blood pressure does not enter the Cox proportional hazards model. In our study sample, the relative impact of blood pressure on the relation between albuminuria and cardiovascular outcome was minor compared with the other risk factors that were included in the model. One reason may be that the LIFE study recruited patients with a relatively narrow blood pressure range (that is, systolic blood pressure between 160 and 200 mm Hg or diastolic blood pressure between 95 and 115 mm Hg) and that the blood pressure range was truncated at each end of the blood pressure spectrum. Because of this, blood pressure's relative impact on the relation between albuminuria and cardiovascular outcome may tend to be underestimated (1). However, although blood pressure itself was not included in the model, we entered the Framingham risk score (2)(which includes blood pressure) when estimating the increased cardiovascular morbidity and mortality per 10-fold increase in UACR. We therefore took any difference in blood pressure and other cardiovascular risk factors between levels of albuminuria into account.
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