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Kidney stones linked to heart disease risk in nurses’ cohort

Wednesday July 24, 2013
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In an analysis of data from the Nurses’ Health Study and Health Professionals Follow-up Study involving a total of more than 240,000 participants, a self-reported history of kidney stones was associated with a statistically significant increased risk of coronary heart disease among women, but not among men.

Based on a recent estimate from the National Health and Nutrition Examination Survey, the reported prevalence of a history of nephrolithiasis was 10.6% in men and 7.1% in women. The overall prevalence increased from 3.8% in 1976-80 to 8.8% in 2007-10, researchers wrote in the July 24/31 issue of the Journal of the American Medical Association.

Pietro Manuel Ferraro, MD, of Columbus-Gemelli Hospital in Rome, and colleagues analyzed the relation between kidney stones and risk of incident coronary heart disease for individuals with a history of kidney stones. The analysis included 45,748 men and 196,357 women in the United States without a history of CHD at baseline who were participants in the Health Professionals Follow-up Study (45,748 men, ages 40 to 75; follow-up from 1986 to 2010), Nurses’ Health Study I (90,235 women, ages 30 to 55; follow-up from 1992 to 2010) and Nurses’ Health Study II (106,122 women, ages 25 to 42; follow-up from 1991 to 2009).

Of a total of 242,105 participants, 19,678 reported a history of kidney stones. After up to 24 years of follow-up in men and 18 years in women, 16,838 incident cases of CHD occurred.

In both Nurses’ Health Study cohorts, multivariable-adjusted analysis of individual outcomes confirmed an association between history of kidney stones and myocardial infarction and revascularization, the authors wrote. After pooling the two cohorts, women with a history of kidney stones had an increased risk of CHD, fatal and nonfatal myocardial infarction and revascularization.

After multivariable adjustment, the researchers found no significant association between history of kidney stones and CHD in the men’s cohort.

The authors said the apparent gender disparity “is difficult to explain, even though we could not determine whether [it] was due to sex or some other difference between the male and female cohorts. However, differences by sex are not infrequent in studies analyzing the association between nephrolithiasis and either CHD or risk factors for CHD.”

Study abstract: http://jama.jamanetwork.com/article.aspx?articleid=1719741.


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