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首页> 外文期刊>Diabetes care >Does albuminuria predict cardiovascular outcomes on treatment with losartan versus atenolol in patients with diabetes, hypertension, and left ventricular hypertrophy? The LIFE study.
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Does albuminuria predict cardiovascular outcomes on treatment with losartan versus atenolol in patients with diabetes, hypertension, and left ventricular hypertrophy? The LIFE study.

机译：在糖尿病，高血压和左心室肥厚的患者中，白蛋白尿能否预测氯沙坦与阿替洛尔治疗的心血管结局？生活研究。

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OBJECTIVE: Our current aims were to investigate whether 1) baseline urinary albumin-to-creatinine ratio (UACR) predicted cardiovascular outcomes, 2) changes in UACR differed between treatments, 3) benefits of losartan were related to its influence on UACR, and 4) reduction in albuminuria reduced cardiovascular events. RESEARCH DESIGN AND METHODS: In 1,063 patients with diabetes, hypertension, and left ventricular hypertrophy, UACR was measured for a mean of 4.7 years. The primary composite end point included cardiovascular death, myocardial infarction, and stroke. Cox models were run including and excluding baseline and time-varying UACR. RESULTS: Increasing baseline albuminuria related to increased risk for cardiovascular events. Reductions in UACR at years 1 and 2 were approximately 33% for losartan vs. 15% for atenolol (P < 0.001). Benefits of losartan seem to be most prominent in patients with the highest level of baseline UACR, although treatment by albuminuria interaction was only significant fortotal mortality. Approximately one-fifth of the superiority of losartan was explained by the greater reduction of albuminuria. Risk of the primary end point was related to the in-treatment UACR. CONCLUSIONS: Lowering of albuminuria in patients with hypertension and diabetes appears to be beneficial and should be the subject of additional study in future clinical trials.
机译：目的：我们目前的目的是调查1）基线尿白蛋白/肌酐比值（UACR）预测的心血管结果，2）UACR的变化在两种治疗方法之间存在差异，3）氯沙坦的益处与其对UACR的影响有关，以及4 ）减少蛋白尿可减少心血管事件。研究设计与方法：在1,063名糖尿病，高血压和左心室肥厚患者中，UACR的平均测量值为4.7年。主要的复合终点包括心血管死亡，心肌梗塞和中风。运行Cox模型，包括但不包括基线和时变UACR。结果：基线白蛋白尿增加与心血管事件风险增加有关。氯沙坦第1年和第2年的UACR降低约33％，而阿替洛尔降低15％（P <0.001）。在基线UACR水平最高的患者中，氯沙坦的益处似乎最为显着，尽管通过蛋白尿相互作用治疗仅能显着降低总死亡率。氯沙坦的优越性约有五分之一是由蛋白尿的减少所致。主要终点的风险与治疗中的UACR有关。结论：降低高血压和糖尿病患者的蛋白尿似乎是有益的，并且应该成为未来临床试验中进一步研究的对象。

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