An Analysis of Cardiovascular Risk Factors in 995 Chronic Dialysis Patients: A-CARD Study ---- the Role of Age

九百九十五位慢性血液透析病人心臟血管疾病及其危險因子之分析：年紀的影響

洪士元(S. Y. Hung) ； 劉宏祥(H. H. Liou) ； 陳良根(L. K. Chen) ； 劉美琴(M. C. Liu) ； 鍾孝民(H. M. Chung) ； A-CARD研究小組(A-CARD Study Group)

《Acta Nephrologica》 14卷4期 (2000/10) Pp. 300-300

並列摘要

Cardiovascular disease is the most common cause of mortality in chronic HD patients. Age, male older than 45 and female older than 55, was considered as one of the major coronary heart disease (CHD) risk factors in the report of the NCEP (ATP II & III). However, the lipid profile in HD patients, higher serum TG & lower HDL levels, was different from that in general population. Therefore, the risk factors of CHD in HD patients may be different. We conducted a multicenter, cross-sectional survey to evaluate the impact of age on CHD in HD patients. Nine hundred and ninety five ESRD patients who received HD for at least 3 months & aged 20 years or older were included. In the group of patients whose age ＜55 (Group A, n=454), BMI, fasting blood sugar sugar, cholesterol, LDL-C, APO-B, TC/HDL were significantly lower than patients whose age ≥55 (Group B, n=541); while DBP, BUN, Cr, I-PTH, albumin and hematocrit were significantly higher. Systolic BP, TG and Lp (a) levels were found no difference between group A and B. The prevalence rate of CHD, stroke and peripheral vascular disease IPVD) were 15.6%, 2.4%, 2.0% in Group A & 29.4%, 9.1%, 8.1% in Group B, respectively. The prevalence rate of CHD and stroke increased abruptly when male older than 45 and female older than 55. Male had higher prevalence rate of CHD than female with the same age. In conclusion, the lipid profile of chronic HD patients whose age was 55 or greater were more artherogenic. The prevalence rate of CHD, stroke and PVD were higher in the aged HD patients. Even the guidelines of ATP are not applicable in chronic HD patients, as we previously reported; the impact of age on CHD remained the same as in the general population.