Heart failure admission across glomerular filtration rate categories in a community cohort of 125,053 individuals over 60 years of age

Laia Alcober-Morte, Carmen Barrio-Ruiz, Neus Parellada-Esquius, Isaac Subirana, Josep Comín-Colet, Maria Grau, Irene R. Dégano, Miguel Cainzos-Achirica, Oriol Cunillera-Puértolas, Sílvia Cobo-Guerrero, Jordi Mestre-Ferrer, Luisa Pascual-Benito, M. Jesús Cerain-Herrero, Neus Gil-Terrón, Luisa Rodríguez-Latre, Carmen Tamayo-Ojeda, Betlem Salvador-González

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

A reduced estimated glomerular filtration rate (eGFR) has been described as a predictor of heart failure (HF). However, the increased risk across eGFR categories has not been fully evaluated, which is especially relevant in older individuals in whom both the prevalence of HF and decreased eGFR are higher. Furthermore, this association has not been studied in Mediterranean populations, where coronary heart disease (CHD), a frequent cause of HF, has a low prevalence. We performed a retrospective cohort study using the electronic medical records from primary and hospital settings in northeastern Spain. We included 125,053 individuals ≥60 years old with the determination of creatinine and without diagnosis or previous admission due to HF. The eGFR was calculated according to the CKD-EPI formula and classified by clinical categories. The association between eGFR, as a continuous and categorical variable, and the risk of admission due to HF was assessed by Cox proportional risk analysis, considering death as a competitive risk. During a median follow-up of 38.8 months, 2,176 individuals (1.74%) were hospitalized due to HF. The unadjusted admission rates were 4.02, 13.0, 26.0, and 48.6 per 1000 person-years for eGFR > 60, 45–59, 30–44, and 15–29 ml/min/1.73 m2, respectively. The corresponding hazard ratios (95% confidence interval; reference eGFR 60–89) were 1.38 (95% CI 1.23–1.55), 2.02 (95% CI 1.76–2.32) and 3.46 (95% CI 2.78–4.31). In this Mediterranean community-based cohort of individuals ≥60 years old without previous HF, the risk of admission due to HF gradually increased with decreasing eGFR.

Original languageEnglish (US)
Pages (from-to)2013-2020
Number of pages8
JournalHypertension Research
Volume42
Issue number12
DOIs
StatePublished - Dec 1 2019
Externally publishedYes

Keywords

  • Glomerular filtration rate
  • Heart failure
  • Older adults
  • Primary care
  • Risk factor

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

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