Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
E-pub ahead of print

Creatinine increase following initiation of antihypertensives is associated with cardiovascular risk: a nationwide cohort study

Research output: Contribution to journalJournal articleResearchpeer-review

  1. Retinal arteriolar wall-to-lumen ratios at 16-17 years in the Copenhagen Child Cohort 2000 Study

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Obesity remains a major risk factor associated with vascular stiffening in type 2 diabetes

    Research output: Contribution to journalConference abstract in journalResearchpeer-review

  3. Left ventricular hypertrophy identified by cardiac computed tomography and ECG in hypertensive individuals: a population-based study

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Incidence of acute myocardial infarction-related cardiogenic shock during corona virus disease 19 (COVID-19) pandemic

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Hypertension, cardiovascular disease and cause of death in Danish living kidney donors: matched cohort study

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Catheter ablation and mortality, stroke and heart failure readmission with atrial fibrillation

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Effect of Dapagliflozin in DAPA-HF According to Background Glucose-Lowering Therapy

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

OBJECTIVE: Abrupt decline in renal function following initiation of renin-angiotensin system inhibitor is associated with increased risk of cardiovascular disease, but studies of other antihypertensive drugs are sparse. We investigated the risk of cardiovascular event associated with increased plasma creatinine after initiating first-line antihypertensive treatment.

METHODS: In a nationwide cohort study, we identified adult Danish primary care patients initiating either renin-angiotensin system inhibitor, calcium channel blocker or thiazide, between 2008 and mid-2018. Patients with prior end-stage renal disease, renal transplantation, or cardiovascular disease were excluded. Percentual plasma creatinine increase was calculated between the nearest creatinine measurement up to 1 year before redeeming the prescription (baseline), and the nearest measurement 90 days or less after (index). Multiple logistic regression and restricted cubic splines were applied to estimate the 6-month absolute risk of cardiovascular event (ischemic heart disease, heart failure or stroke) associated with this creatinine increase.

RESULTS: We included 20 789 patients. Within the first 6 months of follow-up, 283 (1.4%) cardiovascular events and 93 (0.4%) all-cause deaths were registered. With a creatinine increase of 0 and 30%, 6-month absolute risk [CI] of cardiovascular event was 1.4% [1.1-1.9] and 3.5% [2.4-5.2], respectively (in men aged 50-79 years with estimated glomerular filtration rate at least 60 ml/min per 1.73 m and no diabetes). Higher age and reduced renal function, but not the type of antihypertensive treatment, were associated with higher cardiovascular risk.

CONCLUSION: In primary care, patients initiating first-line antihypertensive treatment, an increase in plasma creatinine above 30% was associated with increased absolute 6-month risk of cardiovascular event.

Original languageEnglish
JournalJournal of Hypertension
ISSN0263-6352
DOIs
Publication statusE-pub ahead of print - 15 Jul 2020

ID: 60569236