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Albuminuria and Cardiovascular Risk in Hypertensive Patients with Left Ventricular Hypertrophy: The LIFE Study

Kristian Wachtell, MD, PhD; Hans Ibsen, MD; Michael H. Olsen, MD, PhD; Knut Borch-Johnsen, MD; Lars H. Lindholm, MD; Carl Erik Mogensen, MD; Björn Dahlöf, MD, PhD; Richard B. Devereux, MD; Gareth Beevers, MD; Ulf de Faire, MD; Frej Fyhrquist, MD; Stevo Julius, MD; Sverre E. Kjeldsen, MD; Krister Kristianson, PhD; Ole Lederballe-Pedersen, MD; Markku S. Nieminen, MD; Peter M. Okin, MD; Per Omvik, MD; Suzanne Oparil, MD; Hans Wedel, PhD; Steven M. Snapinn, PhD; and Peter Aurup, MD
[+] Article and Author Information

From Glostrup University Hospital, Glostrup, Denmark; Steno Diabetes Centre, Gentofte, Denmark; Norrland University Hospital, Umeå, Sweden; Århus University Hospital, Århus, Denmark; Sahlgrenska University Hospital-Östra and The Nordic School of Public Health, Göteborg, Sweden; The Weill Medical College of Cornell University, New York, New York; Dudley Road Hospital, Birmingham, United Kingdom; Institute of Environmental Medicine, Stockholm, Sweden, Helsinki University Hospital, Helsinki, Finland; University of Michigan Medical Center, Ann Arbor, Michigan; Ullevål Sykehus, Oslo, Norway; Merck Research Laboratories, Sollentuna, Sweden; Viborg University Hospital, Viborg, Denmark; Haukeland University Hospital, Bergen, Norway; University of Alabama, Birmingham, Alabama; and Merck & Co., Inc., Whitehouse Station, New Jersey.


Acknowledgments: The authors thank Sigrid Helle Berg for her extensive work on the LIFE study.

Grant Support: By unrestricted grants from Merck & Co., Inc.

Potential Financial Conflicts of Interest:Employment: K. Kristianson, S.M. Snapinn, P. Aurup (Merck & Co., Inc.); Consultancies: K. Wachtell, H. Ibsen, M.H. Olsen, L.H. Lindholm, B. Dahlöf, R.B. Devereux, G. Beevers, U. de Faire, F. Fyhrquist, S. Julius, S.E. Kjeldsen, O. Lederballe-Pedersen, M.S. Nieminen, P.M. Okin, P. Omvik, S. Oparil (Merck & Co., Inc.); Stock ownership: K. Kristianson, S.M. Snapinn, P. Aurup (Merck & Co., Inc.); Grants received: K. Wachtell, H. Ibsen, M.H. Olsen, B. Dahlöf, R.B. Devereux, G. Beevers, U. de Faire, F. Fyhrquist, S. Julius, S.E. Kjeldsen, M.S. Nieminen, P.M. Okin, P. Omvik, S. Oparil (Merck & Co., Inc.).

Requests for Single Reprints: Kristian Wachtell, MD, PhD, Department of Medicine (M41), Glostrup University Hospital, Glostrup, DK-2600 Glostrup, Denmark; e-mail, kristian@wachtell.net.

Current Author Addresses: Drs. Wachtell, Ibsen, and Olsen: Department of Medicine (M41), Glostrup University Hospital, DK-2600 Glostrup, Denmark.

Dr. Borch-Johnsen: Steno Diabetes Centre, Niels Steensens Vej 2, DK-2820 Gentofte, Denmark.

Dr. Lindholm: Department of Preventive Medicine, Norrland University Hospital, S-901 85 Umeå, Sweden.

Dr. Mogensen: Å rhus University Hospital, Nørrebrogade 44, DK-8000 Århus, Denmark.

Dr. Dahlöf: Department of Medicine, Sahlgrenska University Hospital-Östra, S-416 85 Göteborg, Sweden.

Drs. Wachtell, Devereux, and Okin: Department of Cardiology, The Weill Medical College of Cornell University, 525 East 68th Street, New York, NY 10021.

Dr. Beevers: Dudley Road Hospital, Dudley Road, Birmingham B18 7QH, United Kingdom.

Dr. de Faire: Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institute, PO Box 210, S-171 77 Stockholm, Sweden.

Dr. Fyhrquist: Department of Cardiology, Helsinki University Hospital, Haartmaninkatu 4, SF-00290 Helsinki, Finland.

Dr. Julius: University of Michigan Medical Center, 3918 Taubman Center, Ann Arbor, MI 48109-0356.

Dr. Kjeldsen: Department of Cardiology, Ullevål Sykehus, N-0407 Oslo, Norway.

Dr. Kristianson: Merck Research Laboratories, Box 7125, S-192 07, Sollentuna, Sweden.

Dr. Lederballe-Pedersen: Department of Medicine, Viborg University Hospital, DK-8800 Viborg, Denmark.

Dr. Nieminen: Department of Cardiology, Helsinki University Hospital, Haartmaninkatu 4, SF-00290 Helsinki, Finland.

Dr. Omvik: Department of Cardiology, Haukeland University Hospital, N-5021 Bergen, Norway.

Dr. Oparil: Department of Physiology and Biophysics, University of Alabama, MCLM 704, 1918 University Boulevard, Birmingham, AL 35294-0005.

Dr. Wedel: The Nordic School of Public Health, Box 12133, S-402 42 Göteborg, Sweden.

Drs. Snapinn and Aurup: Merck & Co., Inc., 1 Merck Drive, Whitehouse Station, NJ 08889-0100.

Author Contributions: Conception and design: K. Wachtell, H. Ibsen, M.H. Olsen, K. Borch-Johnsen, L.H. Lindholm.

Analysis and interpretation of the data: K. Wachtell, H. Ibsen, M.H. Olsen, K. Borch-Johnsen, L.H. Lindholm, S.M. Snapinn.

Drafting of the article: K. Wachtell, H. Ibsen, M.H. Olsen, K. Borch-Johnsen, L.H. Lindholm.

Critical revision of the article for important intellectual content: K. Wachtell, H. Ibsen, M.H. Olsen, K. Borch-Johnsen, L.H. Lindholm, B. Dahlöf, R.B. Devereux, S.M. Snapinn.

Final approval of the article: K. Wachtell, H. Ibsen, M.H. Olsen, K. Borch-Johnsen, L.H. Lindholm, B. Dahlöf, R.B. Devereux, G. Beevers, U. de Faire, F. Fyhrquist, S. Julius, S.E. Kjeldsen, K. Kristianson, O. Lederballe-Pedersen, M.S. Nieminen, P.M. Okin, P. Omvik, S. Oparil, H. Wedel, S.M. Snapinn, P. Aurup.

Provision of study materials or patients: K. Wachtell, H. Ibsen, M.H. Olsen, K. Borch-Johnsen, L.H. Lindholm, B. Dahlöf, R.B. Devereux, G. Beevers, U. de Faire, F. Fyhrquist, S. Julius, S.E. Kjeldsen, K. Kristianson, O. Lederballe-Pedersen, M.S. Nieminen, P.M. Okin, P. Omvik, S. Oparil, H. Wedel, S.M. Snapinn, P. Aurup.

Statistical expertise: K. Wachtell, S.M. Snapinn.

Obtaining of funding: K. Kristianson, P. Aurup.

Administrative, technical, or logistic support: K. Wachtell, B. Dahlöf, K. Kristianson, P. Aurup.

Collection and assembly of data: K. Wachtell, K. Kristianson, S.M. Snapinn, P. Aurup.


Ann Intern Med. 2003;139(11):901-906. doi:10.7326/0003-4819-139-11-200312020-00008
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To our knowledge, this is the first study to prospectively evaluate the effect of albuminuria in a large group of hypertensive patients with left ventricular hypertrophy on cardiovascular morbidity and mortality. As UACR increased, risk for subsequent cardiovascular events in hypertensive patients continuously increased, and there appear to be no unique thresholds at which increased albuminuria predicts cardiovascular morbidity and mortality.

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Summary for Patients

Microalbuminuria Increases Risk for Heart Attacks and Strokes in Hypertensive Patients

The summary below is from the full report titled “Albuminuria and Cardiovascular Risk in Hypertensive Patients with Left Ventricular Hypertrophy: The LIFE Study.” It is in the 2 December 2003 issue of Annals of Internal Medicine (volume 139, pages 901-906). The authors are K. Wachtell, H. Ibsen, M.H. Olsen, K. Borch-Johnsen, L.H. Lindholm, C.E. Mogensen, B. Dahlöf, R.B. Devereux, G. Beevers, U. de Faire, F. Fyhrquist, S. Julius, S.E. Kjeldsen, K. Kristianson, O. Lederballe-Pedersen, M.S. Nieminen, P.M. Okin, P. Omvik, S. Oparil, H. Wedel, S.M. Snapinn, and P. Aurup.

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