title: The association between glomerular filtration rate and stroke in hypertensive patients in rural areas of China.
abstract: OBJECTIVE
  The present study is to explore the association between estimated glomerular filtration rate (eGFR) and stroke in hypertensive patients in rural areas of China.
  
  
  METHODS
  The prospective study was based on 3711 hypertensive patients who were aged at least 35 years, free from cardiovascular diseases, and had serum creatinine at baseline. eGFR was estimated using the Chronic Kidney Disease Epidemiology Collaboration equation.
  
  
  RESULTS
  During a median follow-up of 4.9 years, 176 first-ever strokes (98 ischemic, 75 hemorrhagic, and three were unspecified strokes) occurred. We found no independent association between eGFR and risk of hemorrhagic stroke. In contrast, with decreasing eGFR, the risk of total and ischemic stroke strongly increased; the sex and age-adjusted hazard ratios for overall and ischemic stroke were 3.34 [95% confidence interval (CI) 1.61-6.93] and 3.79 (95% CI 1.33-10.81) for patients with eGFR below 60 versus eGFR at least 90  ml/min per 1.73 m, respectively. In addition, patients with an eGFR of 60-90 relative to eGFR at least 90  ml/min per 1.73 m had hazard ratios of 2.31 (95% CI 1.53-3.51) and 3.24 (95% CI 1.76-6.00) for overall and ischemic stroke after adjustment for sex and age, respectively. Adjustment for other cardiovascular factors only slightly attenuated the associations.
  
  
  CONCLUSIONS
  The patients with decreased eGFR, also included those with eGFR range between 60 and 90  ml/min per 1.73 m, had an independently increased risk of overall and ischemic stroke in hypertensive patients in rural areas of China.
authors.affiliation: Department of Clinical Epidemiology, Library, Shengjing Hospital of China Medical University, Shenyang, People's Republic of China.
authors.forename: Liqiang
authors.initials: L
authors.lastname: Zheng
authors.forename: Zhaoqing
authors.initials: Z
authors.lastname: Sun
authors.forename: Xingang
authors.initials: X
authors.lastname: Zhang
authors.forename: Jue
authors.initials: J
authors.lastname: Li
authors.forename: Dayi
authors.initials: D
authors.lastname: Hu
authors.forename: Yingxian
authors.initials: Y
authors.lastname: Sun
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D002309:Cardiology / Q000379:methods; D002681:China; D016000:Cluster Analysis; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D012306:Risk; D012307:Risk Factors; D012424:Rural Population; D020521:Stroke / Q000150:complications* / Q000175:diagnosis