ASSOCIATION BETWEEN CHRONIC KIDNEY DISEASE AND MAJOR CARDIOVASCULAR EVENTS: VALE DO VOUGA COHORT ANALYSIS

Abstract

Introduction: Reduced GFR and increased albuminuria are established markers of high cardiovascular risk and poor prognosis. Chronic kidney disease (CKD) is an independent risk factor for major cardiovascular events, yet it remains frequently underdiagnosed and undertreated.
Objective: This study aimed to characterize hypertensive patients with major cardiovascular events and to evaluate the association with CKD, considering comorbidities, laboratory parameters, and pre-event therapy.
Methods: A retrospective observational study was conducted, including hypertensive patients with major cardiovascular events followed in a Family Health Unit between 2014 and 2024. Inclusion criteria were based on ICPC-2 codes K74, K75, K76, K89, and K90, excluding non-hypertensive patients, pregnant women, and those under 18 years. Data were retrieved from MIM@UF® and SClínico® and analyzed with IBM SPSS®.
Results: A total of 160 patients were included (69.4% male; mean age 67.1 ± 10.6 years). The most frequent events were stroke (33.1%) and ischemic heart disease with angina (31.3%). The most prevalent comorbidities were dyslipidemia (89.4%), type 2 diabetes (45%), obesity (33%), and CKD (13.1%). Mean laboratory values included serum creatinine 0.94 mg/dL, albuminuria 24.0 mg/g and LDL 106.9 mg/dL. Approximately 14.4% had GFR <60 mL/min/1.73m2. Pre-event therapy included angiotensin-converting enzyme inhibitors in 51.2%, angiotensin receptor blockers in 23.7%, and sodium-glucose cotransporter-2 inhibitors (SGLT2i) in only 1.9%.
Conclusion: These findings highlight the relevant prevalence of CKD, possibly underdiagnosed, and the low use of SGLT2i despite the high prevalence of diabetes, reflecting significant gaps in clinical practice. Given the robust evidence supporting SGLT2i in renal and cardiovascular protection, early identification of CKD and optimization of therapy are crucial strategies to reduce the burden of major cardiovascular events and improve patient outcomes.