Gauging adequacy of cardiovascular disease treatment: importance of estimating glomerular filtration rate and time-varying albuminuria

Objective measures of cardiovascular disease (CVD) are often lacking until patients develop clinical symptomatology associated with either coronary, cerebral, or peripheral vascular disease. Estimating risk for CVD is often based on classic Framingham Heart Study criteria such as age, gender, blood pressure (BP), cholesterol, glucose levels, and family history. Moreover, there is a well-described continuous relationship between BP,cholesterol, and glucose and risk for cardiovascular events. Estimating glomerular filtration rate equations using simple formulae and screening quantitatively for albuminuria may provide an important opportunity for identifying patients at increased risk for cardiovascular events. These safe, simple, and cost-effective measures of estimating CVD risk can be used to gauge the adequacy of response to cardiovascular risk-reducing therapies.