The impact of occult renal failure on the cardiovascular risk stratification in an elderly population: the PREV-ICTUS study.
OBJECTIVE
To analyze the impact of occult renal failure (ORF) in the individual risk stratification and on the blood pressures (BP) and low-density lipoprotein (LDL) goals in an aged population, according to the ESH/ESC Hypertension Guidelines.


METHODS
A cross-sectional, population-based study on individuals aged 60 years or more carried out in Primary Care Centers of Spain. Kidney function was estimated from calculated creatinine clearance (eGFR), Cockroft and Gault formula. Ten-year cardiovascular risk was estimated through the ESH/ESC table including or not including the eGFR. Estimates of the modification in BP and LDL-cholesterol (cLDL) goals were calculated.


RESULTS
In 6419 subjects, 4242 subjects (66%) had normal renal function, 1971 (31%) had ORF (normal creatinine and low eGFR) and 206 (3%) had insufficient renal function (high creatinine and all of them low eGFR). Inclusion of ORF as target organ damage resulted in an increase in the estimated risk in 10.8% of the total sample, increasing the percentage of high-risk subjects. In the latter case, new BP and cLDL goals (<130/80 mmHg and <100 mg/dl) should be needed in 475 (7.4%) and 413 (6.4%) additional subjects, respectively.


CONCLUSIONS
Inclusion of the ORF resulted in a significant increase in the percentage of subjects with estimated high cardiovascular risk.
Redón
Josep
J
Hypertension Clinic, Hospital Clinico Universitario, Universidad de Valencia, Spain. josep.redon@uv.es
Gil
Vicente
V
Cea-Calvo
Luis
L
Lozano
José V
JV
Martí-Canales
Juan C
JC
Llisterri
José L
JL
Aznar
Jose
J
González-Esteban
Jorge
J
D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000503:physiopathology*; D008078:Cholesterol, LDL / Q000097:blood; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology; D016015:Logistic Models; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D044382:Population Groups; D017410:Practice Guidelines as Topic; D051437:Renal Insufficiency / Q000453:epidemiology* / Q000503:physiopathology*; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology
D008078:Cholesterol, LDL; D003404:Creatinine