CO-07: Prognostic value of protein intake assessed by 24-hour urinary excretion in hypertension - 12/02/16
Valeur pronostique de l'apport protéique é valué sur l'urine des 24 heures dans l'hypertension artérielle
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Résumé |
Background |
Protein intake may have some favorable influence on blood pressure and cardiovascular events but the results are controversial. The objective of the present study was to test the prognostic value of protein intake assessed by 24-hour urinary excretion in a cohort of hypertensive subjects with preserved renal function.
Methods |
1.128 hypertensive patients with a 24-hour urinary analysis were initially included in the present study. They were classified according to tertiles of protein intake adjusted for ideal body weight (IBW, the IBW was derived by using a BMI value of 22kg/m2 as a reference): 1: <0.70, 2: 0.70–0.93 and 3: >0,93g/kg.
Results |
Baseline characteristics were: age 45.1±13.2 years, blood pressure 185±32 / 107±20mmHg and eGFR 82±32ml/min. After a 10-year follow-up, there were 289 deaths of whom 177 from cardiovascular cause. As shown by Kaplan-Meier curves, the survival rates decrease for patients in the lowest tertile either for all-cause mortality (p=0.008) for cardiovascular mortality (p=0.161) and for non-cardiovascular mortality (p=0.036).
After adjustment for major cardiovascular risk factors, patients in the second and third tertiles had a decrased risk of all-cause (HR 0.73; 95% CI [0.57-0.95]), cardiovascular (HR 0.78; 95% CI [0.56-1.08]), and non-cardiovascular death (HR 0.63; 95% CI [0.43-0.94]) in comparison to those belonging to the first one. Exclusion of patients with eGFR <45ml/ min or secondary hypertension or who died in the first year of follow-up demonstrated similar results. High protein intake had a more marked positive influence in a subset of our population: younger, low salt intake, absence of aortic atherosclerosis or previous cardiovascular events (p for interaction <0.10 for all) (see figure above).
Abstract CO-07 – Figure
Abstract CO-07 – Figure
Conclusions |
We demonstrated that a protein intake above 0,7g/kg of IBW had a protective effect on the prognostic value of all-cause, cardiovascular and non-cardiovascular mortality in hypertensive patients. This may be due to the fact that some amino-acids (arginine and tryptophan) may influence bioavailability of NO. These mechanisms have probably a major role to preserve endothelial function. This is consistent with the results we observed: the effect of protein intake is particularly observed when the endothelium is preserved in young hypertensive patients without overt cardiovascular disease.
Le texte complet de cet article est disponible en PDF.Vol 64 - N° S1
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