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Small Increases In Phosphorus May Mean Higher Risk of Heart Disease
WASHINGTON, DC -- November 5, 2009 -- Higher levels of phosphorus in the blood are linked to increased calcification of the coronary arteries -- a key marker of heart disease risk, according to a study published early online and appearing in an upcoming issue of the Clinical Journal of the American Society of Nephrology.
"This may help to explain why even early-stage chronic kidney disease (CKD) is associated with increased cardiovascular risk that is not otherwise explained by traditional risk factors," said Katherine R. Tuttle, MD, Providence Medical Research Center, Spokane, Washington.
The study looked at the relationship between phosphorus levels and coronary artery calcification (CAC) in nearly 900 healthy adults from the Spokane Heart Study, a long-term study of heart disease risk factors.
Previous studies have linked CAC -- an early sign of atherosclerosis -- to an increased risk of myocardial infarction and other cardiovascular events. At the start of the study, 28% of the participants had CAC.
After 6 years' follow-up, another 33% of participants had developed CAC. For those who already had CAC, the level of CAC increased during follow-up.
The relationship between phosphorus levels and CAC remained significant even after adjustment for other factors. "Even small increases in the blood level of phosphorus predicted an increased risk of progressive CAC in these apparently healthy adults," said Dr. Tuttle.
The phosphorus-related increase in CAC was comparable with that seen with traditional heart disease risk factors like high blood pressure and high cholesterol.
In addition, participants with lower levels of kidney function -- even if not below the normal range -- were more likely to have progressive CAC. Recent studies have linked higher phosphorus levels to increased CAC in patients with CKD as well.
"More research will be needed to see if treatments to lower phosphorus levels can reduce heart disease risk in people with early-stage CKD, or even those without CKD who have CAC," said Dr. Tuttle.
The study had some important limitations, including the use of estimated kidney function levels. In addition, it did not address several factors that can affect phosphorus levels, such as parathyroid hormone and vitamin D.
SOURCE: American Society of Nephrology
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