Physical and biochemical predictors of death in an Australian Aboriginal cohort

1. Predictors of natural and cardiovascular death were examined in a cohort from a remote Australian Aboriginal community with high mortality rates. T he cohort was marked by high prevalences of diabetes (17%), hypertension (1 9% diastolic blood pressure (BP) >90 mmHg), obesity (16% body mass index (B MI) >30), albuminuria (26% albumin/creatinine ratio (ACR) greater than or e qual to 34 g/mol) and renal failure (26% calculated glomerular filtration r ate <80 mL/min). 2. Relationships between baseline characteristics and subsequent mortality were examined using multivariate techniques. 3. Albuminuria, diabetes and hypertension (but not smoking dyslipidaemia or obesity) were all markers for increased risk of natural and especially of cardiovascular death. Age- and sex-adjusted relative risk [95% CI] of natur al deaths were 4.3 [1.9-9.5] for overt albuminuria (ACR greater than or equ al to 34, 3.2 (range 1.6-6.5) for diastolic BP greater than or equal to 100 and 3.7 (range 1.5-8.9) for diabetes. 4. The relative risk associated with albuminuria was independent of diabete s and hypertension. Albuminuria was more common than either diabetes or hyp ertension and represents a target for intervention to reduce not only progr ession to renal disease, but also overall mortality.