Briganti Esther M, Kerr Peter G, Shaw Jonathan E, Zimmet Paul Z, Atkins Robert C
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Nephrology (Carlton). 2005 Feb;10(1):40-7. doi: 10.1111/j.1440-1797.2005.00357.x.
To evaluate the prevalence and treatment of cardiovascular disease and traditional cardiovascular disease risk factors in Australian adults with renal insufficiency.
The Australian Diabetes, Obesity and Lifestyle Study was a cross-sectional survey of Australian adults undertaken in 1999-2000. Participants were categorized based on the Cockcroft-Gault estimated glomerular filtration rate in terms of normal renal function (<60 mL/min per 1.73 m(2)) and renal insufficiency (<60 mL/min per 1.73 m(2)). Outcome measures were the prevalence of cardiovascular disease, estimated risk of cardiovascular disease (20% over 10 years) and traditional cardiovascular risk factors, and frequency of pharmacological treatment of traditional cardiovascular risk factors.
Among adults with renal insufficiency, cardiovascular disease was present in 29.4 (95% CI: 25.1-33.6) per 100, with an additional 47.9 (95% CI: 44.9-50.9) per 100 having an estimated risk of cardiovascular disease (20% over 10 years). At least one cardiovascular risk factor was present in 90.1%. Hypertension and type 2 diabetes mellitus were three times more frequent, while hyperlipidaemia was nearly twice as frequent in those participants with renal insufficiency. Of those with renal insufficiency, 58.2% with hypertension were treated, with only 14.5% of this group being treated to current recommended target levels of blood pressure, while only 32.5% with hyperlipidaemia were treated, with 7.4% of this group being treated to target lipid levels.
The present study demonstrates significant scope to reduce the high burden of cardiovascular risk factors in Australian adults with renal insufficiency in the general community, through treatment of traditional risk factors for cardiovascular disease.
评估澳大利亚肾功能不全成年人中心血管疾病及传统心血管疾病危险因素的患病率和治疗情况。
澳大利亚糖尿病、肥胖与生活方式研究是1999 - 2000年对澳大利亚成年人进行的一项横断面调查。参与者根据Cockcroft - Gault估计肾小球滤过率分为肾功能正常(每1.73平方米<60毫升/分钟)和肾功能不全(每1.73平方米<60毫升/分钟)两类。观察指标为心血管疾病的患病率、心血管疾病估计风险(10年内20%)、传统心血管危险因素以及传统心血管危险因素的药物治疗频率。
在肾功能不全的成年人中,每100人中有29.4人(95%置信区间:25.1 - 33.6)患有心血管疾病,另有每100人中有47.9人(95%置信区间:44.9 - 50.9)有心血管疾病估计风险(10年内20%)。90.1%的人至少存在一种心血管危险因素。肾功能不全参与者中高血压和2型糖尿病的发生率是正常人的三倍,高脂血症的发生率几乎是正常人的两倍。在肾功能不全患者中,58.2%的高血压患者接受了治疗,但该组中只有14.5%的患者血压治疗达到当前推荐目标水平;而高脂血症患者中只有32.5%接受了治疗,该组中7.4%的患者血脂治疗达到目标水平。
本研究表明,通过治疗心血管疾病的传统危险因素,在普通社区中降低澳大利亚肾功能不全成年人中心血管危险因素的高负担有很大空间。