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Proteinuria is an independent risk factor for first incident stroke in adults under treatment for hypertension in China
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نویسنده
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zhang c. ,wang x. ,he m. ,qin x. ,tang g. ,xu x. ,wang y. ,huo y. ,cai y. ,fu j. ,zhao g. ,dong q. ,xu x. ,wang b. ,hou f.f.
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منبع
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journal of the american heart association - 2015 - دوره : 4 - شماره : 12
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چکیده
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Background-conflicting evidence exists regarding whether reduced estimated glomerular filtration rate (egfr) and proteinuria are independent risk factors for stroke and its subtypes in hypertensive patients. this study investigated the association of these renal measures with first incident stroke in adults under treatment for hypertension in china. methods and results-the study included 19 599 adults aged 45 to 75 years who participated in the china stroke primary prevention trial. baseline egfr was calculated using the chronic kidney disease epidemiology collaboration creatinine equation. proteinuria was assessed by qualitative dipstick urinalysis and in a subset by the quantitative albumin-creatinine ratio method. cox regression analysis was used to examine the effects of egfr and proteinuria on the risk of first incident stroke. during a median of 4.5 years of follow-up,a total of 585 first strokes (472 ischemic strokes) were identified. compared to participants without proteinuria,participants with proteinuria (trace or more by dipstick) had a 35% increased risk of first stroke: the adjusted hazard ratio (hr) (95% ci) was 1.35 (1.09-1.66,p=0.005). the results were robust in subgroup analyses. in a subset with data on proteinuria measured by quantitative albumin-creatinine ratio,a similar association was found. in both independent and combined analyses with proteinuria,egfr was not significantly associated with stroke. conclusions-in adults under treatment for hypertension in china,baseline proteinuria measured by dipstick or quantitative albumin-creatinine ratio,but not reduced egfr,was found to be an independent risk factor for first incident stroke and ischemic stroke. © 2015 the authors.
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کلیدواژه
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Albumin-creatinine ratio; Chinese hypertensive adults; Estimated glomerular filtration rate; First incident stroke; proteinuria
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آدرس
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national clinical research study center for kidney disease,state key laboratory for organ failure research,renal division,nanfang hospital,southern medical university,guangzhou, China, department of population,family and reproductive health,johns hopkins university,bloomberg school of public health,baltimore,md, United States, department of neurology,first people's hospital,lianyungang, China, national clinical research study center for kidney disease,state key laboratory for organ failure research,renal division,nanfang hospital,southern medical university,guangzhou, China, institute for biomedicine,anhui medical university,hefei, China, national clinical research study center for kidney disease,state key laboratory for organ failure research,renal division,nanfang hospital,southern medical university,guangzhou, China, national clinical research study center for kidney disease,state key laboratory for organ failure research,renal division,nanfang hospital,southern medical university,guangzhou, China, cardiology department,peking university first hospital,beijing, China, department of neurology,guangdong provincial hospital of chinese medicine,guangzhou, China, department of neurology,first affiliated hospital,anhui medical university,hefei, China, department of neurology,xijing hospital,fourth military medical university,xi'an, China, department of neurology,huashan hospital,fudan university,shanghai, China, national clinical research study center for kidney disease,state key laboratory for organ failure research,renal division,nanfang hospital,southern medical university,guangzhou,china,ausa research institute,shenzhen ausa pharmed co ltd,shenzhen, China, national clinical research study center for kidney disease,state key laboratory for organ failure research,renal division,nanfang hospital,southern medical university,guangzhou, China, national clinical research study center for kidney disease,state key laboratory for organ failure research,renal division,nanfang hospital,southern medical university,guangzhou, China
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Authors
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