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Cardiovascular events were increased in patients with high cardiovascular risk who had albuminuria

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 QUESTION: Is any degree of albuminuria a risk factor for cardiovascular (CV) events in high risk patients with or without diabetes mellitus (DM)?


Cohort study of patients enrolled in the Heart Outcomes Prevention Evaluation (HOPE) study with a median 4.5 years of follow up.


Community and academic practices in Europe and North and South America.


9043 patients ≥ 55 years of age who had a history of previous CV disease (either coronary artery disease, stroke, or peripheral vascular disease) or a history of DM plus ≥ 1 other CV risk factor (total cholesterol concentration > 5.2 mmol/l, high-density lipoprotein cholesterol concentration ≤ 0.9 mmol/l, hypertension, known microalbuminuria, or current smoker). Exclusion criteria included dipstick-positive proteinuria or established diabetic nephropathy, other renal disease, hyperkalemia, congestive heart failure (CHF), low-ejection fraction, and hypersensitivity to vitamin E or angiotensin-converting enzyme inhibitors.

Assessment of risk factors

Baseline data were collected on age, sex, smoking …

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  • Sources of funding: Medical Research Council of Canada; Hoechst Marion Roussell; Astra; Natural Source Vitamin E Association; NEGMA; King Pharmaceuticals.

  • For correspondence: Dr H C Gerstein, Department of Medicine, McMaster University, Room 3V38, 1200 Main Street West, Hamilton, Ontario L8N 3Z5, Canada. Fax +1 905 521 4971.