Kidney dysfunction is associated with risk of cardiovascular events in middle-aged and elderly population with hypertension: A 5-year community-based cohort study in China

Aim: To evaluate the association between kidney dysfunction and cardiovascular disease (CVD) events in a middle-aged and elderly population in China. Materials and methods: In July 2009, a baseline survey of health status was performed in adults aged 55 years and older from Beijing, China. Occurrence of CVD events and mortality in subjects free of CVD at baseline was recorded in a 5-year follow-up period until December 2014. The association of mild (eGFR(CKD-EPI) 45 - 59 mL/min/1.73m(2)) and moderate to severe (eGFR(CKD-EPI) < 45 mL/min/1.73m(2)) kidney dysfunction with adverse outcomes were analyzed with Cox regression analysis. Results: A total of 1,257 subjects were included in the final analysis. The risk of CVD events in those with mild kidney dysfunction increased by 65% (HR: 1.65, 95% CI: 1.04 - 2.62) as compared to those with normal kidney function. Subjects with both hypertension and CKD experienced more significantly increased risk of CVD events (adjusted HR = 1.87, 95% CI 1.17 - 2.97) and stroke (adjusted HR = 2.24, 95% CI 1.24 - 4.04). Pulse pressure (PP) >= 60 mmHg was the strongest risk factor for stroke in patients with CKD, with the adjusted HR value of 1.98 (95% CI 1.08 - 3.64). Conclusion: Moderate to severe kidney dysfunction was an independent risk predictor of CVD events. Among subjects with hypertension or poorly controlled blood pressure level, the presence of CKD significantly increased the risks of CVD events and stroke.