Abstract
During the past 50 years, a dramatic reduction in the mortality rate associated with cardiovascular disease has occurred in the US and other countries. Statistical modeling has revealed that approximately half of this reduction is the result of risk factor mitigation. The successful identification of such risk factors was pioneered and has continued with the Framingham Heart Study, which began in 1949 as a project of the US National Heart Institute (now part of the National Heart, Lung, and Blood Institute). Decreases in total cholesterol, blood pressure, smoking, and physical inactivity account for 24%, 20%, 12%, and 5% reductions in the mortality rate, respectively. Nephrology was designated as a recognized medical professional specialty a few years later. Hemodialysis was first performed in 1943. The US Medicare End-Stage Renal Disease (ESRD) Program was established in 1972. The number of patients in the program increased from 5,000 in the first year to more than 500,000 in recent years. Only recently have efforts for risk factor identification, early diagnosis, and prevention of chronic kidney disease (CKD) been undertaken. By applying the approach of the Framingham Heart Study to address CKD risk factors, we hope to mirror the success of cardiology; we aim to prevent progression to ESRD and to avoid the cardiovascular complications associated with CKD. In this paper, we present conceptual examples of risk factor modification for CKD, in the setting of this historical framework.
Highlights
CONTRASTING CARDIOLOGY AND NEPHROLOGYOver the last half century, we have witnessed a global reduction in the coronary heart disease mortality rate by approximately 60% (Figure 1).[1]
By applying the approach of the Framingham Heart Study to address chronic kidney disease (CKD) risk factors, we hope to mirror the success of cardiology; we aim to prevent progression to end-stage renal disease (ESRD) and to avoid the cardiovascular complications associated with CKD
Cardiovascular disease mortality rates in the US dramatically decreased from 805 deaths per 100,000 people in 1963 to 236 per 100,000 people in 2010.2 Before that time, the incidence of cardiovascular disease-related death was on the rise
Summary
Over the last half century, we have witnessed a global reduction in the coronary heart disease mortality rate by approximately 60% (Figure 1).[1] Cardiovascular disease mortality rates in the US dramatically decreased from 805 deaths per 100,000 people in 1963 to 236 per 100,000 people in 2010.2 Before that time, the incidence of cardiovascular disease-related death was on the rise. The analysis gave rise to the concept of risk factors for coronary disease, including hypertension, high cholesterol, and smoking. This recognition led to vigorous risk-reduction campaigns.[4,5,6]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
