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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)?

Design

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

Setting

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

Participants

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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