This document provides an overview of hypertension including:
- Prevalence rates in various countries including the US, China, Egypt, and Saudi Arabia
- Guidelines for classifying blood pressure levels from organizations like JNC 7 and ESC/ESH
- Consequences of uncontrolled hypertension like increased risks of stroke, myocardial infarction, heart failure, and kidney disease
- Results from clinical trials demonstrating reduced risks with tighter blood pressure control
- Recommendations for achieving blood pressure targets and choosing antihypertensive medications
This lecture presents the 1-Updated recommendations regarding definition and proper diagnosis of HTN. 2-Updated guidelines for threshold of BP to start treatment and targets of treatment. 3- Updated recommendations on CV risk assessment and management. 4-Hypertension and comorbidities: updated guidelines
This lecture presents the 1-Updated recommendations regarding definition and proper diagnosis of HTN. 2-Updated guidelines for threshold of BP to start treatment and targets of treatment. 3- Updated recommendations on CV risk assessment and management. 4-Hypertension and comorbidities: updated guidelines
This presentation focus on the accurate method of BP measurement as well as the presentation of the latest clinical trials of hypertension management and their impact on recent guidelies
Hypertension is another name for high blood pressure. It can lead to severe health complications and increase the risk of heart disease, stroke, and sometimes death. Blood pressure is the force that a person's blood exerts against the walls of their blood vessels.
Hypertension (HTN or HT), also known as high blood pressure (HBP), is a long-term medical condition in which the blood pressure in the arteries is persistently elevated.
this presentation have various hypertension management guidelines used in the Indian context, hypertension management algorithm, medication used and AYUSH interventions
Management of Hypertension and Diabetes in Aging People 2014Nemencio Jr
This module discusses the issues in the management and treatment goals for hypertension and diabetes in the older population based on the most recent guidelines
This presentation focus on the accurate method of BP measurement as well as the presentation of the latest clinical trials of hypertension management and their impact on recent guidelies
Hypertension is another name for high blood pressure. It can lead to severe health complications and increase the risk of heart disease, stroke, and sometimes death. Blood pressure is the force that a person's blood exerts against the walls of their blood vessels.
Hypertension (HTN or HT), also known as high blood pressure (HBP), is a long-term medical condition in which the blood pressure in the arteries is persistently elevated.
this presentation have various hypertension management guidelines used in the Indian context, hypertension management algorithm, medication used and AYUSH interventions
Management of Hypertension and Diabetes in Aging People 2014Nemencio Jr
This module discusses the issues in the management and treatment goals for hypertension and diabetes in the older population based on the most recent guidelines
Epidemiology , diagnosis and treatment of Hypertension Toufiqur Rahman
Hypertension, Blood pressure, Systolic Hypertension, Diastolic Hypertension, Epidemiology, Classification of hypertention, Type of hypertension, aetiology of hypertension, Clinical features, complications of hypertension, ambulatory blood pressure monitoring, Resistant hypertension, anti hypertensives,
Covering everything from which social networks marketers (and teens) love and what drives engagement to how social media influences sales and why Facebook dominates, these numbers will influence your marketing strategy.
My slides of the Webinar with Singularity University on 9 Design Principles on Exponential (10X) Business Models. I have studied over 50 business models to discover patterns on exponential features. You can find examples of Zappos, Netflix here and 9 design principles based on the business model canvas.
‘Everything Available’ – a vision for the development of the British Library ...Torsten Reimer
Presentation given at the annual RLUK (Research Libraries UK) conference on Thursday 9th March 2017. I discuss the British Library's 'Everything Available' portfolio that aims to transform the Library's research services, in particular around discovery, access and use of content.
Personal Branding: Women's Private Equity Forum Half Moon Bay, CA March 2017Jennifer Jones & Partners
Personal branding is a requirement today. It’s not just about self-promotion. It’s about finding a signature image, a unique voice, and a recognizable standard that your friends, customers and others can grow to appreciate. It’s knowing what you are best at doing and not being afraid to put it out there. It’s having the confidence to project a persona and live in it.
The Airbnb engineering team have released a library for converting After Effect animation to JSON file, that you can use for native apps. I'm going to share my short experience of using Lottie for an iOS project.
- Presentation made for Melborune Cocoaheads, March 2017
Get the latest announcements on Microsoft and NVIDIA's HGX-1 platform for artificial intelligence cloud computing, Facebook's new AI server, and the launch of Jetson TX2 for AI computing in cameras, sensors, and more.
Diabetes and acute coronary syndrome
Diabetic patients as compared to non diabetics withacute cornary syndrome (ACS) at 2 years showed a
1.8 fold increase in cardiovascular deaths
1.4 fold increase in myocardial infarctions (MI)
www.srisriholistichospitals.com
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
2. Case 1
40 y.o. white male was found to have Bp (158/92) on
pre-employment physical exam.
A) ARB
B) ACE I
C) B blocker
D) Diuretic
E) Calcium Ch blocker
F) None of the above
11. ESC/ESH 2007
Bp (mmHg) with different measurement
SBP DBP
Office or clinic 140 90
24-hour 125 -130 80
Day 130 – 135 85
Night 120 70
Home 130-135 85
European Heart Journal 2007
15. Framingham Heart Study - Risk of Cardiovascular Events by Hypertensive Status in
Patients Aged 35-64 Years; 36-Year Follow-Up
9.5
3.3 2.4
5
2
3.5
2.1
45.4
21.3
12.4
6.2
9.9
7.3
13.9
6.3
22.7
0
10
20
30
40
50
Men Women Men Women Men Women Men Women
Normotensive
Hypertensive
Risk Ratio 2.0 2.2 3.8 2.6 2.0 3.7 4.0 3.0
Excess Risk 22.7 11.8 9.1 3.8 4.9 5.3 10.4 4.2
Coronary Disease Stroke Peripheral Artery
Disease
Cardiac Failure
BiennialAge-AdjustedRate
per1000
Kannel WB JAMA 1996;275(24):1571-1576.
16. HealthStatus/QOL
Time, years
Normotensive
Elevated Blood Pressure
Left Ventricular
Dysfunction
Heart Failure
LowerHigher
Death
Renal Impairment
Decline in
Glomerular
Filtration Rate
Kidney Failure
Vascular Hypertrophy
Stroke
Consequences of Hypertension
Am Heart J. 1991;121:1244–1263.
17. 0
5
10
15
20
0 100 200 300
5YearRisk(%)
Stroke
Myocardial
Infarction
Systolic Blood Pressure (mmHg)
Differing influence of hypertension on
absolute and relative risk of stroke and MI
Brown, M.J. Lancet 2000; 355: 659 - 660
20 40 60 80 120 140 160 180 220 240 260 280
Normotensives Hypertensives
18. MI and Stroke in Hypertension Trials
N Engl J Med 2003
0
1
2
3
4
5
6
7
8
Percentageofpatientswithevent
Stroke
Myocardial Infarction
19. The circadian pattern of BP
Weber M.A. et al., Rev Cardiovasc Med 2004
24-hour BP levels
20. The circadian pattern of BP
Weber M.A. et al., Rev Cardiovasc Med 2004
Correlation with CV events (ISAM study)
SCD
21.
22. Proteinuria: predicting cardiovascular events and
survival in diabetes
A: U-Prot <150 mg/L B: U-Prot 150–300 mg/L C: U-Prot >300 mg/L
Incidence
(%)
Survival
Months
A
B
C
Overall p<0.001
1.0
0.9
0.8
0.7
0.6
0.5
0
0 10 30 50 70 90 Stroke Coronary
Events
0
10
20
30
40
Overall
p<0.001
Overall
p<0.001
U-Prot=concentration of urinary protein
Miettinen et al. Stroke 1996; 27: 2033–9
23. What level of blood pressure should
be achieved?
BHS 2004
<140/85 mm Hg (<130/80 for diabetics)1
ESH/ESC 2003 + 2007
<140/80 mm Hg (<130/80 for diabetics)2
JNC 7: 2003
<140/90 mm Hg (<130/80 for diabetics)3
1. Williams et al. J Hum Hypertens 2004;18:139–85
2. Guidelines committee. J Hypertens 2003;21:1011–53
3. Chobanian et al. Hypertension 2003;42:1206–52
24. AASK MAP <92
Target BP (mm Hg)
Multiple antihypertensive agents
are needed to achieve target BP
No. of antihypertensive agents
1
UKPDS DBP <85
ABCD DBP <75
MDRD MAP <92
HOT DBP <80
Trial 2 3 4
DBP, diastolic blood pressure; MAP, mean arterial pressure; SBP, systolic blood pressure.
Bakris GL et al. Am J Kidney Dis. 2000;36:646-661.
Lewis EJ et al. N Engl J Med. 2001;345:851-860.
Cushman WC et al. J Clin Hypertens. 2002;4:393-404.
IDNT SBP <135/DBP <85
ALLHAT SBP <140/DBP <90
25. Value of excellent vs. good blood pressure control in NIDDM
(144/82 vs. 154/87mmHg)
0
10
20
30
40
0 1 2 3 4 5 6 7 8
9
PatientsWithEvents(%)
Less tight control
Tight control
Years From Randomisation
UKPDS, BMJ 1998;317:703-713.
Reduction in risk with tight control 32% (95% CI 6% to 51%) (P=0.019)
27. SBP Control in Trials *
Mancia and Grassi, J Hypert 2002
FACET
Micro HOPE
CAPPP
INSIGHT
HOT
VALUE
STOP-2
UKPDS
LIFE
RENAAL
IDNT
IRMA
ABCD
130
140
150
160
170
180
190
200
mmHg
120
Diabetic
s
B T
ALLHAT 1
HOPE
PROGRESS
CAPPP
INSIGHT
NORDIL
HOT
STONE
STOP-2
LIFE
ALLHAT 2
ANBP2
INVEST
SCOPE
ASCOT
VALUE
All
patients
130
140
150
160
170
180
190
200
mmHg
B T
* Most patients under ≥ 2 drugs
28. USA
27
Canada
13
England
6
France
24
Adapted from G. Mancia / L.Adapted from G. Mancia / L.
RuilopeRuilope
< 140/90 mmHg
MarquesMarques--Vidal P et al. JVidal P et al. J Hum HypertensHum Hypertens 19971997
Percentages of Patients whose
Hypertension is Controlled
Percentages of Patients whosePercentages of Patients whose
Hypertension is ControlledHypertension is Controlled
Finland Spain
20
Germany Scotland
< 160/95 mmHg
Australia
19
India
9
20.5
17.522.5
> 65 years
USA:USA: JNC VI.JNC VI. Arch Intern MedArch Intern Med 19971997
Canada:Canada: JoffresJoffres et al.et al. AmAm JJ HypertensHypertens 20012001
England:England: Colhoun et al. J Hypertens 1998Colhoun et al. J Hypertens 1998
France:France: Chamontin etChamontin et al.al. AmAm JJ HypertensHypertens
19981998
29.
30.
31.
32. Limitations of Clinical Trials
• Mostly high risk / elderly patients:
i.e. younger / low risk patients are not represented
• Short durations (4 – 5 years):
i.e. the extra 20 – 30 years are not studied
• Multiple combined primary end points:
i.e. single end point as a beneficial effect, can not be concluded
• Limitations of meta-analysis:
i.e.: by definition, they are post-hoc analysis
33. Facts that we now know:
• Antihypertensive Rx = Less CV morbidity & mortality
• The benefits extend to isolated systolic hypertension
• The beneficial effect is present across men & women in various ethnic
groups
• 30 -40% risk reduction in stroke
• 20% risk reduction in coronary events
• Large reduction in heart failure
34.
35. 25
Biochemical Results –
Fasting Glucose – mg/dL
100.5 (19.5)*103.1 (27.7)104.4 (28.5)4 Years
Diabetes Incidence (follow-up fasting glucose 126 mg/dL)
Among baseline nondiabetics with baseline <126 mg/dL
Total
4 Years
Baseline
4 Years
Baseline
8.1%*9.8%*11.6%
93.3 (11.8)93.0 (11.4)93.1 (11.7)
121.5 (51.3)*123.7 (52.0)126.3 (55.6)
122.9 (56.1)123.1 (57.0)123.5 (58.3)
LisinoprilAmlodipineChlorthalidone
*p<.05 compared to chlorthalidone
ALLHAT
41. Choosing drugs for patients newly diagnosed with hypertension
< 55 years > 55 years or black patients at any age
A* C or D
A* + C or A* + D
A* + C + D
Consider 4th line drug:
Further diuretic therapy or
Alpha blocker or Beta blocker
A = ACE inhibitor (* consider ARB if ACE intolerant)
C = calcium channel blocker D = thiazide type diuretic
42. Conclusions
• Hypertension is the commonest cause of major
morbidity, but less than a quarter of patients are
adequately treated.
• A reduction in cardiovascular disease mortality and
morbidity can be achieved through improved treatment
and control of hypertension.
• A greater choice of drugs are available for hypertension
than for other chronic diseases
• Rational choice of single and combination drugs
facilitated by understanding their effects on the renin
system, but systematic trial and error may still be
necessary
Editor's Notes
It is well known that untreated hypertension can cause a progressive decline to cardiac failure or kidney failure.
3
Circadian rhythms - the body’s 24-hour pattern of cyclical activity - have attracted attention for many years, most frequently with respect to the human sleep-wake cycle.
A number of studies have assessed the impact of circadian variations on blood pressure (BP). BP levels follow a typical pattern: they are highest in the early morning and then decline to a trough value after midnight, to rise again at awakening (“morning surge”).
Weber M.A. et al.; Rev Cardiovasc Med 5 (3): 148-155; 2004
Several large-scale epidemiological studies have shown that adverse cardiovascular events occur unevenly during the circadian cycle, peaking in the early hours after awakening.
An analysis of the data from the ISAM study, for example, demonstrated a circadian pattern in the incidence of MI: researchers timed the occurrence of MI on the basis of the onset of clinical symptoms, and found a significantly higher incidence between 6 a.m. and noon than in the other periods of the day.
There is also evidence showing a circadian variation in the occurrence of sudden cardiac death, which was more prevalent between 7 and 11 a.m.
Weber M.A. et al.; Rev Cardiovasc Med 5 (3): 148-155; 2004
Proteinuria: predicting cardiovascular events and survival in diabetes
Increased urinary albumin and protein excretion is associated with cardiovascular disease mortality independent of other cardiovascular risk factors in patients with type 2 diabetes. In a 7-year follow up of non-diabetic and type 2 diabetic patients, survival in type II diabetics was also shown to be related to the severity of proteinuria experienced by the patients (no proteinuria, borderline proteinuria and overt proteinuria). Furthermore, as well as overall survival, the incidence of cardiovascular events such as stroke, non-fatal myocardial infarction and coronary events also increase with severity of proteinuria.
These findings are compatible with the hypothesis that increased urinary protein excretion is not merely an indicator of renal damage, but may be indicative of more widespread vascular damage.