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Circulating des-acyl ghrelin improves cardiovascular risk prediction in older hypertensive patients.
- Source :
-
American journal of hypertension [Am J Hypertens] 2014 May; Vol. 27 (5), pp. 727-33. Date of Electronic Publication: 2013 Dec 21. - Publication Year :
- 2014
-
Abstract
- Background: We aimed to assess the predictive value of circulating levels of des-acyl ghrelin, an abundant form of ghrelin in humans, for the risk of cardiovascular disease (CVD) in older hypertensive patients. We simultaneously evaluated other biomarkers, such as high-molecular-weight (HMW) adiponectin, high-sensitivity C-reactive protein (hs-CRP), and plasminogen activator inhibitor 1 (PAI-1), for their usefulness in risk prediction.<br />Methods: We enrolled 590 older hypertensive patients (mean age = 72.9 years; 41.0% men). The incidences of CVD, including coronary artery disease, stroke, congestive heart failure, and sudden death, were prospectively ascertained.<br />Results: During an average duration of 2.8 (SD = 0.7) years (1,653 person-years), there were 42 CVD events. Patients with CVD events had lower levels of des-acyl ghrelin at baseline than those without CVD events (median = 78.2 vs. 114.7 fmol/ml; P < 0.001). No difference was found among other biomarkers between the patients with CVD events and those without such events. The Cox proportional hazards model adjusted by covariables revealed that the hazard ratio for CVD events in patients with a 1-SD decrease of log des-acyl ghrelin was 1.8 (95% confidence interval = 1.3-2.4). Incorporation of des-acyl ghrelin in the risk model (including age, current smoking, 24-hour systolic blood pressure, preexisting CVD, and carotid intima-media thickness) improved the C statistics (from 0.683 to 0.721; P = 0.22) and resulted in a net reclassification improvement of 20.5% (P = 0.02). In contrast, HMW adiponectin, hs-CRP, and PAI-1 provided no improvement in risk prediction.<br />Conclusions: Des-acyl ghrelin improved the prediction of CVD events in older hypertensive patients.
- Subjects :
- Adiponectin blood
Age Factors
Aged
Aged, 80 and over
Biomarkers blood
C-Reactive Protein analysis
Chi-Square Distribution
Female
Humans
Hypertension diagnosis
Hypertension mortality
Incidence
Japan epidemiology
Male
Middle Aged
Plasminogen Activator Inhibitor 1 blood
Predictive Value of Tests
Prognosis
Proportional Hazards Models
Prospective Studies
Risk Assessment
Risk Factors
Time Factors
Ghrelin blood
Hypertension blood
Subjects
Details
- Language :
- English
- ISSN :
- 1941-7225
- Volume :
- 27
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- American journal of hypertension
- Publication Type :
- Academic Journal
- Accession number :
- 24363280
- Full Text :
- https://doi.org/10.1093/ajh/hpt232