title: Chronic kidney disease and cardiovascular disease in a general Japanese population: the Hisayama Study.
abstract: BACKGROUND
  Chronic kidney disease has been shown to be an independent risk factor for cardiovascular disease in high-risk populations. However, this relationship is inconclusive in community-based populations.
  
  
  METHODS
  To clarify this issue, we followed 2634 community-dwelling individuals without cardiovascular disease, aged 40 years or older, for 12 years and examined the relationship between chronic kidney disease and the incidence of cardiovascular disease.
  
  
  RESULTS
  During the follow-up period, 99 subjects (56 men and 43 women) experienced coronary heart disease, 137 subjects (60 men and 77 women) ischemic stroke, and 60 subjects (26 men and 34 women) hemorrhagic stroke. In men, the age-adjusted incidence of coronary heart disease was significantly higher in subjects with chronic kidney disease than in those without it (6.2 vs. 2.9 per 1000 person-years) (P < 0.05), but such a relationship was not observed with ischemic stroke. In contrast, in women, the age-adjusted incidence of ischemic stroke was significantly higher in subjects with chronic kidney disease than in those without it (3.4 vs. 2.5) (P < 0.05), while that of coronary heart disease was not. Chronic kidney disease was not found to be associated with the incidence of hemorrhagic stroke. In multivariate analysis, even after adjustments for traditional and nontraditional cardiovascular disease risk factors, chronic kidney disease was found to be an independent risk factor for the occurrence of coronary heart disease in men [hazard ratio (HR), 2.26; 95% CI, 1.06-4.79], and for the occurrence of ischemic stroke in women (HR, 1.91; 95% CI, 1.15-3.15).
  
  
  CONCLUSIONS
  Our findings suggest that chronic kidney disease is an independent risk factor for the occurrence of cardiovascular disease in the general Japanese population.
authors.affiliation: Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. nino@intmed2.med.kyushu-u.ac.jp
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Ninomiya
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kiyohara
authors.forename: Michiaki
authors.initials: M
authors.lastname: Kubo
authors.forename: Yumihiro
authors.initials: Y
authors.lastname: Tanizaki
authors.forename: Yasufumi
authors.initials: Y
authors.lastname: Doi
authors.forename: Ken
authors.initials: K
authors.lastname: Okubo
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Wakugawa
authors.forename: Jun
authors.initials: J
authors.lastname: Hata
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Oishi
authors.forename: Kentaro
authors.initials: K
authors.lastname: Shikata
authors.forename: Koji
authors.initials: K
authors.lastname: Yonemoto
authors.forename: Hideki
authors.initials: H
authors.lastname: Hirakata
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Iida
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003324:Coronary Artery Disease / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology