This Article Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Jager, A. Articles by Stehouwer, C. D. A. Search for Related Content PubMed PubMed Citation Articles by Jager, A. Articles by Stehouwer, C. D. A. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Medline Plus Health Information High Blood Pressure Peripheral Arterial Disease Related Collections Risk Factors Peripheral vascular disease Epidemiology

(Arteriosclerosis, Thrombosis, and Vascular Biology. 1999;19:617-624.)
© 1999 American Heart Association, Inc.

Original Contributions

Microalbuminuria and Peripheral Arterial Disease Are Independent Predictors of Cardiovascular and All-Cause Mortality, Especially Among Hypertensive Subjects

Five-year Follow-up of the Hoorn Study

Agnes Jager; Piet J. Kostense; Henricus G. Ruhé; Robert J. Heine; Giel Nijpels; Jacqueline M. Dekker; Lex M. Bouter; Coen D. A. Stehouwer

From the Institute for Research in Extramural Medicine (A.J., P.J.K., H.G.R., R.J.H., G.N., J.M.D., L.M.B., C.D.A.S.), Department of Epidemiology and Biostatistics (P.J.K., L.M.B.), and Department of Internal Medicine, Academic Hospital (R.J.H., C.D.A.S.), Vrije Universiteit, Amsterdam, The Netherlands.

Correspondence to Dr Coen D.A. Stehouwer, Department of Internal Medicine, Academic Hospital Vrije Universiteit De Boelelaan 1118, 1007 MB Amsterdam, The Netherlands. E-mail cda.stehouwer{at}azvu.nl

Abstract—Microalbuminuria (MA) is associated with increased cardiovascular and all-cause mortality. It has been proposed that MA reflects generalized atherosclerosis and may thus predict mortality. To investigate this hypothesis, we studied the associations between, on the one hand, MA and peripheral arterial disease (PAD), a generally accepted marker of generalized atherosclerosis, and, on the other hand, cardiovascular and all-cause mortality in an age-, sex-, and glucose tolerance-stratified sample (n=631) of a population-based cohort aged 50 to 75 years followed prospectively for 5 years. At baseline, the albumin-to-creatinine ratio (ACR) was measured in an overnight spot urine sample; MA was defined as ACR >2.0 mg/mmol. PAD was defined as an ankle-brachial pressure index below 0.90 and/or a history of a peripheral arterial bypass or amputation. After 5 years of follow-up, 58 subjects had died (24 of cardiovascular causes). Both MA and PAD were associated with a 4-fold increase in cardiovascular mortality. After adjusting for age, sex, diabetes mellitus, hypertension, levels of total and HDL-cholesterol and triglyceride, body mass index, smoking habits, and preexistent ischemic heart disease, the relative risks (RR) (95% confidence intervals) were 3.2 (1.3 to 8.1) for MA and 2.4 (0.9 to 6.1) for PAD. When both MA and PAD were included in the multivariate analysis, the RRs were 2.9 (1.1 to 7.3) for MA and 2.0 (0.7 to 5.7) for PAD. MA and PAD were both associated with an about 2-fold increase in all-cause mortality. The RRs of all-cause mortality associated with MA and PAD were about 4 times higher among hypertensive than among normotensive subjects. We conclude that both MA and PAD are associated with an increased risk of cardiovascular mortality. MA and PAD are mutually independent risk indicators. The associations of MA and PAD with all-cause mortality are somewhat weaker. They are more pronounced in the presence of hypertension than in its absence. These data suggest that MA affects mortality risk through a mechanism different from generalized atherosclerosis.

Key Words: microalbuminuria • peripheral arterial disease • mortality • noninsulin dependent diabetes mellitus • hypertension

This article has been cited by other articles:

				M. Helfand, D. I. Buckley, M. Freeman, R. Fu, K. Rogers, C. Fleming, and L. L. Humphrey Emerging Risk Factors for Coronary Heart Disease: A Summary of Systematic Reviews Conducted for the U.S. Preventive Services Task Force Ann Intern Med, October 6, 2009; 151(7): 496 - 507. [Abstract] [Full Text] [PDF]

				A. H. Brantsma, S. J. L. Bakker, H. L. Hillege, D. de Zeeuw, P. E. de Jong, R. T. Gansevoort, and for the PREVEND Study Group Cardiovascular and renal outcome in subjects with K/DOQI stage 1-3 chronic kidney disease: the importance of urinary albumin excretion Nephrol. Dial. Transplant., December 1, 2008; 23(12): 3851 - 3858. [Abstract] [Full Text] [PDF]

				M. H. Criqui, J. K. Ninomiya, D. L. Wingard, M. Ji, and A. Fronek Progression of Peripheral Arterial Disease Predicts Cardiovascular Disease Morbidity and Mortality J. Am. Coll. Cardiol., November 18, 2008; 52(21): 1736 - 1742. [Abstract] [Full Text] [PDF]

				K. He, K. Liu, M. L Daviglus, E. Mayer-Davis, N. S. Jenny, R. Jiang, P. Ouyang, L. M Steffen, D. Siscovick, C. Wu, et al. Intakes of long-chain n-3 polyunsaturated fatty acids and fish in relation to measurements of subclinical atherosclerosis Am. J. Clinical Nutrition, October 1, 2008; 88(4): 1111 - 1118. [Abstract] [Full Text] [PDF]

				Ankle Brachial Index Collaboration Ankle Brachial Index Combined With Framingham Risk Score to Predict Cardiovascular Events and Mortality: A Meta-analysis JAMA, July 9, 2008; 300(2): 197 - 208. [Abstract] [Full Text] [PDF]

				E. Rademacher, M. Mauer, D. R. Jacobs Jr, B. Chavers, J. Steinke, and A. Sinaiko Albumin Excretion Rate in Normal Adolescents: Relation to Insulin Resistance and Cardiovascular Risk Factors and Comparisons to Type 1 Diabetes Mellitus Patients Clin. J. Am. Soc. Nephrol., July 1, 2008; 3(4): 998 - 1005. [Abstract] [Full Text] [PDF]

				J. Danziger Importance of Low-Grade Albuminuria Mayo Clin. Proc., July 1, 2008; 83(7): 806 - 812. [Abstract] [Full Text] [PDF]

				S. Basi, P. Fesler, A. Mimran, and J. B. Lewis Microalbuminuria in Type 2 Diabetes and Hypertension: A marker, treatment target, or innocent bystander? Diabetes Care, February 1, 2008; 31(Supplement_2): S194 - S201. [Full Text] [PDF]

				S. Sheehan, S.-W. Tsaih, B. L. King, C. Stanton, G. A. Churchill, B. Paigen, and K. DiPetrillo Genetic analysis of albuminuria in a cross between C57BL/6J and DBA/2J mice Am J Physiol Renal Physiol, November 1, 2007; 293(5): F1649 - F1656. [Abstract] [Full Text] [PDF]

				C. Daly Is early chronic kidney disease an important risk factor for cardiovascular disease?: A Background Paper prepared for the UK Consensus Conference on Early Chronic Kidney Disease Nephrol. Dial. Transplant., September 1, 2007; 22(suppl_9): ix19 - ix25. [Full Text] [PDF]

				Authors/Task Force Members:, G. Mancia, G. De Backer, A. Dominiczak, R. Cifkova, R. Fagard, G. Germano, G. Grassi, A. M. Heagerty, S. E. Kjeldsen, et al. 2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC) Eur. Heart J., June 11, 2007; (2007) ehm236v1. [Full Text] [PDF]

				M. R. Weir Microalbuminuria and Cardiovascular Disease Clin. J. Am. Soc. Nephrol., May 1, 2007; 2(3): 581 - 590. [Abstract] [Full Text] [PDF]

				J. M. Mostaza, C. Suarez, L. Manzano, M. Cairols, F. Garcia-Iglesias, J. Sanchez-Alvarez, J. Ampuero, D. Godoy, A. Rodriguez-Samaniego, M. A. Sanchez-Zamorano, et al. Relationship between Ankle-Brachial Index and Chronic Kidney Disease in Hypertensive Patients with No Known Cardiovascular Disease J. Am. Soc. Nephrol., December 1, 2006; 17(12_suppl_3): S201 - S205. [Abstract] [Full Text] [PDF]

				J. Redon, F. Morales-Olivas, A. Galgo, M. A. Brito, J. Mediavilla, R. Marin, P. Rodriguez, S. Tranche, J. V. Lozano, C. Filozof, et al. Urinary Albumin Excretion and Glomerular Filtration Rate across the Spectrum of Glucose Abnormalities in Essential Hypertension J. Am. Soc. Nephrol., December 1, 2006; 17(12_suppl_3): S236 - S245. [Abstract] [Full Text] [PDF]

				C. D.A. Stehouwer and Y. M. Smulders Microalbuminuria and Risk for Cardiovascular Disease: Analysis of Potential Mechanisms J. Am. Soc. Nephrol., August 1, 2006; 17(8): 2106 - 2111. [Abstract] [Full Text] [PDF]

				T. Fukuhara and K. Hida Pulsatility index at the cervical internal carotid artery as a parameter of microangiopathy in patients with type 2 diabetes. J. Ultrasound Med., May 1, 2006; 25(5): 599 - 605. [Abstract] [Full Text] [PDF]

				J. de Jager, J. M. Dekker, A. Kooy, P. J. Kostense, G. Nijpels, R. J. Heine, L. M. Bouter, and C. D.A. Stehouwer Endothelial Dysfunction and Low-Grade Inflammation Explain Much of the Excess Cardiovascular Mortality in Individuals With Type 2 Diabetes: The Hoorn Study Arterioscler Thromb Vasc Biol, May 1, 2006; 26(5): 1086 - 1093. [Abstract] [Full Text] [PDF]

				J. Segura, J. A. Garcia-Donaire, M. Praga, and L. M. Ruilope Chronic Kidney Disease as a Situation of High Added Risk in Hypertensive Patients J. Am. Soc. Nephrol., April 1, 2006; 17(4_suppl_2): S136 - S140. [Abstract] [Full Text] [PDF]

				F. Stam, C. van Guldener, A. Becker, J. M. Dekker, R. J. Heine, L. M. Bouter, and C. D.A. Stehouwer Endothelial Dysfunction Contributes to Renal Function-Associated Cardiovascular Mortality in a Population with Mild Renal Insufficiency: The Hoorn Study J. Am. Soc. Nephrol., February 1, 2006; 17(2): 537 - 545. [Abstract] [Full Text] [PDF]

				G. Montalescot and J.-P. Collet Preserving cardiac function in the hypertensive patient: why renal parameters hold the key Eur. Heart J., December 2, 2005; 26(24): 2616 - 2622. [Abstract] [Full Text] [PDF]

				J. Xu, E. T Lee, L. G Best, M. Begum, W. C Knowler, R. R Fabsitz, and B. V Howard Association of albuminuria with all-cause and cardiovascular disease mortality in diabetes: the Strong Heart Study The British Journal of Diabetes & Vascular Disease, November 1, 2005; 5(6): 334 - 340. [Abstract] [PDF]

				J. M. Dekker, C. Girman, T. Rhodes, G. Nijpels, C. D.A. Stehouwer, L. M. Bouter, and R. J. Heine Metabolic Syndrome and 10-Year Cardiovascular Disease Risk in the Hoorn Study Circulation, August 2, 2005; 112(5): 666 - 673. [Abstract] [Full Text] [PDF]

				J. Redon Urinary Albumin Excretion: Lowering the Threshold of Risk in Hypertension Hypertension, July 1, 2005; 46(1): 19 - 20. [Full Text] [PDF]

				K. P. Klausen, H. Scharling, G. Jensen, and J. S. Jensen New Definition of Microalbuminuria in Hypertensive Subjects: Association With Incident Coronary Heart Disease and Death Hypertension, July 1, 2005; 46(1): 33 - 37. [Abstract] [Full Text] [PDF]

				M. V. van Hecke, J. M. Dekker, C. D.A. Stehouwer, B. C.P. Polak, J. H. Fuller, A. K. Sjolie, A. Kofinis, R. Rottiers, M. Porta, and N. Chaturvedi Diabetic Retinopathy Is Associated With Mortality and Cardiovascular Disease Incidence: The EURODIAB Prospective Complications Study Diabetes Care, June 1, 2005; 28(6): 1383 - 1389. [Abstract] [Full Text] [PDF]

				J. M. Pascual, E. Rodilla, C. Gonzalez, S. Perez-Hoyos, and J. Redon Long-Term Impact of Systolic Blood Pressure and Glycemia on the Development of Microalbuminuria in Essential Hypertension Hypertension, June 1, 2005; 45(6): 1125 - 1130. [Abstract] [Full Text] [PDF]

				E. M. Stuveling, S. J. L. Bakker, H. L. Hillege, P. E. de Jong, R. O. B. Gans, and D. de Zeeuw Biochemical risk markers: a novel area for better prediction of renal risk? Nephrol. Dial. Transplant., March 1, 2005; 20(3): 497 - 508. [Full Text] [PDF]

				F. Viazzi, G. Leoncini, D. Parodi, E. Ratto, S. Vettoretti, V. Vaccaro, A. Parodi, V. Falqui, C. Tomolillo, G. Deferrari, et al. Impact of Target Organ Damage Assessment in the Evaluation of Global Risk in Patients with Essential Hypertension J. Am. Soc. Nephrol., March 1, 2005; 16(3_suppl_1): S89 - S91. [Abstract] [Full Text] [PDF]

				M. Furtner, S. Kiechl, A. Mair, K. Seppi, S. Weger, F. Oberhollenzer, W. Poewe, and J. Willeit Urinary albumin excretion is independently associated with carotid and femoral artery atherosclerosis in the general population Eur. Heart J., February 1, 2005; 26(3): 279 - 287. [Abstract] [Full Text] [PDF]

				H. Kramer, R. Toto, R. Peshock, R. Cooper, and R. Victor Association between Chronic Kidney Disease and Coronary Artery Calcification: The Dallas Heart Study J. Am. Soc. Nephrol., February 1, 2005; 16(2): 507 - 513. [Abstract] [Full Text] [PDF]

				H. Ibsen, M. H. Olsen, K. Wachtell, K. Borch-Johnsen, L. H. Lindholm, C. E. Mogensen, B. Dahlof, R. B. Devereux, U. de Faire, F. Fyhrquist, et al. Reduction in Albuminuria Translates to Reduction in Cardiovascular Events in Hypertensive Patients: Losartan Intervention for Endpoint Reduction in Hypertension Study Hypertension, February 1, 2005; 45(2): 198 - 202. [Abstract] [Full Text] [PDF]

				A. R. Dyer, P. Greenland, P. Elliott, M. L. Daviglus, G. Claeys, H. Kesteloot, H. Ueshima, J. Stamler, and for the INTERMAP Research Group Evaluation of Measures of Urinary Albumin Excretion in Epidemiologic Studies Am. J. Epidemiol., December 1, 2004; 160(11): 1122 - 1131. [Abstract] [Full Text] [PDF]

				J. R. Sowers Treatment of Hypertension in Patients With Diabetes Arch Intern Med, September 27, 2004; 164(17): 1850 - 1857. [Abstract] [Full Text] [PDF]

				R. Korstanje and K. DiPetrillo Unraveling the genetics of chronic kidney disease using animal models Am J Physiol Renal Physiol, September 1, 2004; 287(3): F347 - F352. [Abstract] [Full Text] [PDF]

				A. R. Dyer, P. Greenland, P. Elliott, M. L. Daviglus, G. Claeys, H. Kesteloot, Q. Chan, H. Ueshima, and J. Stamler Estimating Laboratory Precision of Urinary Albumin Excretion and Other Urinary Measures in the International Study on Macronutrients and Blood Pressure Am. J. Epidemiol., August 1, 2004; 160(3): 287 - 294. [Abstract] [Full Text] [PDF]

				K. Klausen, K. Borch-Johnsen, B. Feldt-Rasmussen, G. Jensen, P. Clausen, H. Scharling, M. Appleyard, and J. S. Jensen Very Low Levels of Microalbuminuria Are Associated With Increased Risk of Coronary Heart Disease and Death Independently of Renal Function, Hypertension, and Diabetes Circulation, July 6, 2004; 110(1): 32 - 35. [Abstract] [Full Text] [PDF]

				J. S. Jensen, B. Feldt-Rasmussen, K. S. Jensen, P. Clausen, H. Scharling, and B. G. Nordestgaard Transendothelial lipoprotein exchange and microalbuminuria Cardiovasc Res, July 1, 2004; 63(1): 149 - 154. [Abstract] [Full Text] [PDF]

				C. D. A. Stehouwer Endothelial dysfunction in diabetic nephropathy: state of the art and potential significance for non-diabetic renal disease Nephrol. Dial. Transplant., April 1, 2004; 19(4): 778 - 781. [Full Text] [PDF]

				M. F. Yuyun, K.-T. Khaw, R. Luben, A. Welch, S. Bingham, N. E. Day, and N. J. Wareham A Prospective Study of Microalbuminuria and Incident Coronary Heart Disease and Its Prognostic Significance in a British Population: The EPIC-Norfolk Study Am. J. Epidemiol., February 1, 2004; 159(3): 284 - 293. [Abstract] [Full Text] [PDF]

				M. F Yuyun, K.-T. Khaw, R. Luben, A. Welch, S. Bingham, N. E Day, and N. J Wareham Microalbuminuria independently predicts all-cause and cardiovascular mortality in a British population: The European Prospective Investigation into Cancer in Norfolk (EPIC-Norfolk) population study Int. J. Epidemiol., February 1, 2004; 33(1): 189 - 198. [Abstract] [Full Text] [PDF]

				K. Wachtell, H. Ibsen, M. H. Olsen, K. Borch-Johnsen, L. H. Lindholm, C. E. Mogensen, B. Dahlof, R. B. Devereux, G. Beevers, U. de Faire, et al. Albuminuria and Cardiovascular Risk in Hypertensive Patients with Left Ventricular Hypertrophy: The LIFE Study Ann Intern Med, December 2, 2003; 139(11): 901 - 906. [Abstract] [Full Text] [PDF]

				S. Romundstad, J. Holmen, H. Hallan, K. Kvenild, and H. Ellekjaer Microalbuminuria and All-Cause Mortality in Treated Hypertensive Individuals: Does Sex Matter?: The Nord-Trondelag Health Study (HUNT), Norway Circulation, December 2, 2003; 108(22): 2783 - 2789. [Abstract] [Full Text] [PDF]

				M. J. Sarnak, A. S. Levey, A. C. Schoolwerth, J. Coresh, B. Culleton, L. L. Hamm, P. A. McCullough, B. L. Kasiske, E. Kelepouris, M. J. Klag, et al. Kidney Disease as a Risk Factor for Development of Cardiovascular Disease: A Statement From the American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention Hypertension, November 1, 2003; 42(5): 1050 - 1065. [Full Text] [PDF]

				M. J. Sarnak, A. S. Levey, A. C. Schoolwerth, J. Coresh, B. Culleton, L. L. Hamm, P. A. McCullough, B. L. Kasiske, E. Kelepouris, M. J. Klag, et al. Kidney Disease as a Risk Factor for Development of Cardiovascular Disease: A Statement From the American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention Circulation, October 28, 2003; 108(17): 2154 - 2169. [Full Text] [PDF]

				M. A. Murtaugh, D. R. Jacobs Jr., X. Yu, M. D. Gross, and M. Steffes Correlates of Urinary Albumin Excretion in Young Adult Blacks and Whites: The Coronary Artery Risk Development in Young Adults Study Am. J. Epidemiol., October 1, 2003; 158(7): 676 - 686. [Abstract] [Full Text] [PDF]

				J. M. Murabito, J. C. Evans, M. G. Larson, K. Nieto, D. Levy, and P. W. F. Wilson The Ankle-Brachial Index in the Elderly and Risk of Stroke, Coronary Disease, and Death: The Framingham Study Arch Intern Med, September 8, 2003; 163(16): 1939 - 1942. [Abstract] [Full Text] [PDF]

				G. Leoncini, F. Viazzi, D. Parodi, S. Vettoretti, E. Ratto, M. Ravera, C. Tomolillo, M. Del Sette, G. P. Bezante, G. Deferrari, et al. Mild Renal Dysfunction and Subclinical Cardiovascular Damage in Primary Hypertension Hypertension, July 1, 2003; 42(1): 14 - 18. [Abstract] [Full Text] [PDF]

				A. T Hirsch and A. M Gotto Jr Undertreatment of dyslipidemia in peripheral arterial disease and other high-risk populations: an opportunity for cardiovascular disease reduction Vascular Medicine, November 1, 2002; 7(4): 323 - 331. [Abstract] [PDF]

				R. Pontremoli, G. Leoncini, M. Ravera, F. Viazzi, S. Vettoretti, E. Ratto, D. Parodi, C. Tomolillo, and G. Deferrari Microalbuminuria, Cardiovascular, and Renal Risk in Primary Hypertension J. Am. Soc. Nephrol., November 1, 2002; 13(90003): S169 - 172. [Abstract] [Full Text]

				H. L. Hillege, V. Fidler, G. F.H. Diercks, W. H. van Gilst, D. de Zeeuw, D. J. van Veldhuisen, R. O.B. Gans, W. M.T. Janssen, D. E. Grobbee, P. E. de Jong, et al. Urinary Albumin Excretion Predicts Cardiovascular and Noncardiovascular Mortality in General Population Circulation, October 1, 2002; 106(14): 1777 - 1782. [Abstract] [Full Text] [PDF]

				C. D.A. Stehouwer, M.-A. Gall, J. W.R. Twisk, E. Knudsen, J. J. Emeis, and H.-H. Parving Increased Urinary Albumin Excretion, Endothelial Dysfunction, and Chronic Low-Grade Inflammation in Type 2 Diabetes: Progressive, Interrelated, and Independently Associated With Risk of Death Diabetes, April 1, 2002; 51(4): 1157 - 1165. [Abstract] [Full Text] [PDF]

				A. Jager, V. W.M. van Hinsbergh, P. J. Kostense, J. J. Emeis, G. Nijpels, J. M. Dekker, R. J. Heine, L. M. Bouter, and C. D.A. Stehouwer C-Reactive Protein and Soluble Vascular Cell Adhesion Molecule-1 Are Associated With Elevated Urinary Albumin Excretion but Do Not Explain Its Link With Cardiovascular Risk Arterioscler Thromb Vasc Biol, April 1, 2002; 22(4): 593 - 598. [Abstract] [Full Text] [PDF]

				J. Redon, E. Rovira, A. Miralles, R. Julve, and J. M. Pascual Factors Related to the Occurrence of Microalbuminuria During Antihypertensive Treatment in Essential Hypertension Hypertension, March 1, 2002; 39(3): 794 - 798. [Abstract] [Full Text] [PDF]

				R. Pedrinelli, G. Dell'Omo, G. Penno, and M. Mariani Non-diabetic microalbuminuria, endothelial dysfunction and cardiovascular disease Vascular Medicine, November 1, 2001; 6(4): 257 - 264. [Abstract] [PDF]

				R. C.P. Go, R. Desmond, J. M. Roseman, D. S.H. Bell, C. Vanichanan, and R. T. Acton Prevalence and Risk Factors of Microalbuminuria in a Cohort of African-American Women With Gestational Diabetes Diabetes Care, October 1, 2001; 24(10): 1764 - 1769. [Abstract] [Full Text] [PDF]

				H. C. Gerstein, J. F. E. Mann, Q. Yi, B. Zinman, S. F. Dinneen, B. Hoogwerf, J. P. Halle, J. Young, A. Rashkow, C. Joyce, et al. Albuminuria and Risk of Cardiovascular Events, Death, and Heart Failure in Diabetic and Nondiabetic Individuals JAMA, July 25, 2001; 286(4): 421 - 426. [Abstract] [Full Text] [PDF]

				M. Roest, J. D. Banga, W. M. T. Janssen, D. E. Grobbee, J. J. Sixma, P. E. de Jong, D. de Zeeuw, and Y. T. van der Schouw Excessive Urinary Albumin Levels Are Associated With Future Cardiovascular Mortality in Postmenopausal Women Circulation, June 26, 2001; 103(25): 3057 - 3061. [Abstract] [Full Text] [PDF]

				A. Jager, V. W. M. van Hinsbergh, P. J. Kostense, J. J. Emeis, G. Nijpels, J. M. Dekker, R. J. Heine, L. M. Bouter, and C. D. A. Stehouwer Prognostic implications of retinopathy and a high plasma von Willebrand factor concentration in type 2 diabetic subjects with microalbuminuria Nephrol. Dial. Transplant., March 1, 2001; 16(3): 529 - 536. [Abstract] [Full Text] [PDF]

				A. Jager, P. J. Kostense, G. Nijpels, J. M. Dekker, R. J. Heine, L. M. Bouter, A. J. M. Donker, and C. D. A. Stehouwer Serum Homocysteine Levels Are Associated With the Development of (Micro)albuminuria : The Hoorn Study Arterioscler Thromb Vasc Biol, January 1, 2001; 21(1): 74 - 81. [Abstract] [Full Text] [PDF]

				G.C. Viberti and S.M. Thomas Searching for new coronary heart disease risk factors Eur. Heart J., December 1, 2000; 21(23): 1905 - 1906. [PDF]

				P R J Ames, C Tommasino, J Alves, J D Morrow, L Iannaccone, G Fossati, S Caruso, F Caccavo, and V Brancaccio Antioxidant susceptibility of pathogenic pathways in subjects with antiphospholipid antibodies: a pilot study Lupus, November 1, 2000; 9(9): 688 - 695. [Abstract] [PDF]

				J. S. Jensen, B. Feldt-Rasmussen, S. Strandgaard, M. Schroll, and K. Borch-Johnsen Arterial Hypertension, Microalbuminuria, and Risk of Ischemic Heart Disease Hypertension, April 1, 2000; 35(4): 898 - 903. [Abstract] [Full Text] [PDF]

				R. Pedrinelli, G. Dell'Omo, G. Penno, S. Bandinelli, A. Bertini, V. Di Bello, and M. Mariani Microalbuminuria and Pulse Pressure in Hypertensive and Atherosclerotic Men Hypertension, January 1, 2000; 35(1): 48 - 54. [Abstract] [Full Text] [PDF]

				K. Kario, S. Hoshide, K. Shimada, T. G. Pickering, R. S. Khattar, R. Senior, and A. Lahiri White-Coat Hypertension Versus Sustained Hypertension in Japan • Response • Response Circulation, December 21, 1999; 100 (25): e157 - e158. [Full Text] [PDF]

				A. Jager, V. W. M. van Hinsbergh, P. J. Kostense, J. J. Emeis, J. S. Yudkin, G. Nijpels, J. M. Dekker, R. J. Heine, L. M. Bouter, and C. D. A. Stehouwer von Willebrand Factor, C-Reactive Protein, and 5-Year Mortality in Diabetic and Nondiabetic Subjects : The Hoorn Study Arterioscler Thromb Vasc Biol, December 1, 1999; 19(12): 3071 - 3078. [Abstract] [Full Text] [PDF]

				A. Jager, V. W.M. van Hinsbergh, P. J. Kostense, J. J. Emeis, G. Nijpels, J. M. Dekker, R. J. Heine, L. M. Bouter, and C. D.A. Stehouwer C-Reactive Protein and Soluble Vascular Cell Adhesion Molecule-1 Are Associated With Elevated Urinary Albumin Excretion but Do Not Explain Its Link With Cardiovascular Risk Arterioscler Thromb Vasc Biol, April 1, 2002; 22(4): 593 - 598. [Abstract] [Full Text] [PDF]