Abstract: TH-PO1082
Markers of Modifiable Health Behaviors, Cardiovascular Events, Death, and CKD
Session Information
- CKD: Epidemiology, Risk Factors, Prevention - I
October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 1901 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Schrauben, Sarah J., University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
- Amaral, Sandra, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
- Anderson, Amanda Hyre, University of Pennsylvania, Philadelphia, Pennsylvania, United States
- Feldman, Harold I., University of Pennsylvania, Philadelphia, Pennsylvania, United States
- Dember, Laura M., University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, United States
Background
Chronic kidney disease (CKD) guidelines focus on modifiable health behaviors in the effort to decrease the risk of death and atherosclerotic events, both of which are increased in CKD. However, the effectiveness of these recommendations is relatively unknown since they were based largely on general population research. We examined the relationship of markers of modifiable health behaviors and clinical outcomes among those with and without CKD.
Methods
Data pooled from Atherosclerotic Risk in Communities Study, Multi-Ethnic Study of Atherosclerosis, and Cardiovascular Health Study. CKD defined as estimated glomerular filtration rate (eGFR) <60 ml/min/1.732. Markers of modifiable behaviors: physical activity, blood pressure, smoking, diet, body mass index, and fasting blood glucose. Multivariable adjusted Cox proportional hazards models estimated risk of death and a composite of atherosclerotic events. Effect modification was explored for age.
Results
Those with CKD (n = 8,542): mean 59.7 yrs, eGFR 54.7; without CKD (n=19,188): mean 60.2 yrs, eGFR 77.3. There was evidence of an interaction by age with behaviors for both outcomes. Results reported by <65 and 65+ yrs (see Table). Overall, recommended markers of health behaviors were associated with decreased death and atherosclerotic events. Particularly, controlled BP had a stronger association in CKD.
Conclusion
Markers of modifiable behaviors were associated with reduced risk of death and atherosclerotic events in CKD and without CKD. Blood pressure control had a stronger association among those with CKD.
Targets for Health Behaviors
Reported HR (95% CI) | Non-CKD | CKD | Non-CKD | CKD |
Death | <65 years (n=11,732) | <65 years (n=6,000) | ≥65 years (n=5,936) | ≥65 years (n=2,051) |
Non-Smoking | 0.48 (0.45-0.52) | 0.44 (0.40-049) | 0.66 (0.59-0.73) | 0.75 (0.62-0.90) |
BP <130/80 mmHg | 0.72 (0.66-0.80) | 0.71 (0.63-0.81) | 0.91 (0.84-0.99) | 0.80 (0.70-.92) |
BMI ≥18.5 to <25 kg/m2 | 1.13 (1.04-1.22) | 1.00 (0.89-1.12) | 1.22 (1.13-1.32) | 1.16 (1.02-1.31) |
Phys Activity >150 min/wk | 0.92 (0.85-1.00) | 0.98 (0.88-1.09) | 0.73 (0.67-0.79) | 0.73 (0.64-0.83) |
Diet Score ≥3 | 0.91 (0.84-0.98) | 1.04 (0.95-1.15) | 0.95 (0.88-1.02) | 0.91 (0.80-1.03) |
Fasting blood glucose <126 | 0.74 (0.63-0.87) | 0.61 (0.50-0.73) | 0.67 (0.59-0.77) | 0.87 (0.70-1.06) |
Atherosclerotic Events | ||||
Non-Smoking | 0.60 (0.54-0.67) | 0.62 (0.54-0.71) | 0.81 (0.68-0.96) | 1.00 (0.74-1.36) |
BP <130/80 mmHg | 0.84 (0.74-0.94) | 0.76 (0.65-0.88) | 0.82 (0.72-0.93) | 0.75 (0.62-0.92) |
BMI ≥18.5 to <25 kg/m2 | 0.85 (0.76-0.95) | 0.88 (0.76-1.02) | 1.04 (0.92-1.16) | 1.00 (0.83-1.21) |
Phys Activity >150 min/wk | 0.99 (0.90-1.10) | 1.12 (0.97-1.29) | 0.80 (0.71-0.90) | 0.81 (0.68-0.98) |
Diet Score ≥3 | 0.92 (0.84-1.01) | 1.12 (0.99-1.26) | 1.05 (0.94-1.17) | 1.10 (0.92-1.31) |
Fasting blood glucose <126 | 0.63 (0.52-0.76) | 0.81 (0.64-1.04) | 0.66 (0.55-0.80) | 1.00 (0.75-1.32) |
Funding
- NIDDK Support