Proteinuria and risk of stroke in patients with hypertension: The Kailuan cohort study

Abstract

Proteinuria is associated with stroke, but the effects of changes in proteinuria on stroke risk are not well understood in the hypertensive population. This study examined whether proteinuria changes across 2‐year assessments were associated with incident stroke in individuals with hypertension. We used visit data from 24 300 participants with hypertension of the Kailuan study who were stroke free at baseline. Based on the baseline and 2‐year dipstick screening results, participants were classified as having no, remittent, incident, or persistent proteinuria. The relationship between proteinuria and stroke was analyzed using Cox proportional‐hazards models after adjusting for potential variables. During a median of 6.89‐year follow‐up, we identified 1197 people with stroke. Compared to those with no proteinuria, stroke risk was significantly increased in participants with incident (hazard ratio [HR] 1.41, 95% CI, 1.05‐1.77) and persistent proteinuria (HR 1.49, 95% CI, 1.25‐1.89) after adjustment for other factors, which was consistent in ischemic stroke and intracerebral hemorrhage. No interaction was found between changes of proteinuria and diabetes mellitus in the hypertensive population. Changes in proteinuria exposure, particularly persistent proteinuria, play a role in reflecting the risk of stroke in patients with hypertension.

Visit-to-Visit Variability of Lipids Measurements and the Risk of Stroke and Stroke Types: A Prospective Cohort Study

“…As reported previously, high TG variability was associated with incident microalbuminuria, 32 and renal dysfunction, which is a strong predeictor of incident stroke in previous studies conducted in Kailuan Study. 33,34 Further investigations are required to understand the relationship Table 3. Hazard ratios and 95% confidence intervals of incident stroke by quartiles of triglycerides variability (coefficient of variation) of TG variability, stroke and its subtypes.…”

The association between changes in proteinuria and the risk of cerebral infarction in the Korean population

“…However, it remains uncertain how once manifested but vanishing proteinuria affects the risk of cardiovascular diseases including cerebral infarction. In the Kailuan cohort study, in contrast to incident and persistent proteinuria, remittent proteinuria was not associated with the increase in the all types of stroke including hemorrhagic and ischemic stroke [19]. Additionally, persistent proteinuria increased the risk of myocardial infarction and cardiovascular mortality, whereas resolved proteinuria didn't show the significant association with myocardial infarction and cardiovascular mortality [17].…”

“…Baseline clinical characteristics of study participants according to the changes in proteinuria (N = 276,861). However, there was the only one study directly evaluating the association between changes in proteinuria and the risk of cerebral infarction [19]. Wang et al examined whether changes in proteinuria over 2 year were associated with incident stroke in 24,300 individuals with hypertension [19].…”

“…However, there was the only one study directly evaluating the association between changes in proteinuria and the risk of cerebral infarction [19]. Wang et al examined whether changes in proteinuria over 2 year were associated with incident stroke in 24,300 individuals with hypertension [19]. They found that the risk of ischemic stroke significantly increased in incident proteinuria (1.36 [1.12-1.65]) and persistent proteinuria (1.41 [1.03-1.94]), compared with negative proteinuria [19].…”

“…Wang et al examined whether changes in proteinuria over 2 year were associated with incident stroke in 24,300 individuals with hypertension [19]. They found that the risk of ischemic stroke significantly increased in incident proteinuria (1.36 [1.12-1.65]) and persistent proteinuria (1.41 [1.03-1.94]), compared with negative proteinuria [19]. Their findings indicate that incident proteinuria and persistent proteinuria are potential risk factor for cerebral infarction in hypertensive patients.…”