[Association between the changes in ideal cardiovascular health status and the decline of glomerular filtration rates in medical examination people].

OBJECTIVE: To explore the association between the changes in ideal cardiovascular health (CVH) indices and the renal function.
 Methods: The retrospective cohort study consisted of 837 Chinese individuals from Department of Health Management in the Third Xiangya Hospital. The general information, anthropometry and blood biochemistry were obtained for all subjects from 2008 to 2014, respectively. The 6-year changes of 7 ideal CVH metrics defined by American Heart Association and the estimated glomerular filtration rate (eGFR) were calculated. Linear regression analysis was used to study the association between the changes in the ideal CVH metrics and eGFR. Covariance analysis was used to compare the levels of changes in eGFR stratified by variations of the ideal CVH metrics.
 Results: After 6 years' follow-up, we did not find significant difference in ideal cardiovascular health indexes between 2014 and 2008 [(3.3±1.4) items vs. (3.2±1.3) items, respectively] (P<0.05). However, the eGFR in 2014 was significantly lower than that in 2008 [(99.8±22.7) mL/(min.1.73 m2) vs (104.3±24.9) mL/(min.1.73 m2), respectively] (P<0.01). After adjusting for age, sex, history of hypertension and diabetes, and history of drug usage (antihypertensive, cholesterol-lowering and blood glucose-lowering medication), the changes in ideal CVH metrics were positively associated with the changes in eGFR (β=0.701, P<0.01). With the improved change in ideal CVH metrics from ≤-2 points, -1 point, 0 point, 1 point to ≥2 points, the magnitude of decline in eGFR was gradually decreased , with significant difference (F= 21.71, P<0.01).
 Conclusion: The changes in ideal CVH metrics are an independent risk factor for changes of eGFR. Positive changes in ideal CVH metrics exert a favorable effect on renal function evolution.