Phosphate link to CVD without CKD

High levels of serum phosphorus can increase the risk of cardiovascular disease (CVD) in people without chronic kidney disease (CKD), according to US research.

Previous research had linked high levels of serum phosphorus and calcium-phosphorus with in-creased mortality from CVD in patients with CKD or prior CVD.

But the latest study has shown this might be the case in individuals without CKD or prior CVD.

High serum phosphorus levels increased the risk of a cardiovascular event by 50 per cent in these people.

The latest study involved 3,368 participants, with an average age of 44, who were free of CKD and CVD at baseline.

The researchers measured serum phosphorus and calcium at baseline as well as other CVD risk factors including BP, smoking status and alcohol intake.

All participants were followed up for any CVD events and death by examining hospital records, patient records and pathology reports, where necessary.

Over the course of the 20-year follow-up period, there were 524 reported CVD events.

This included 173 cases of angina, 28 sudden cardiac deaths and 63 cases of peripheral vascular disease.

The prevalence of several established CVD risk factors decreased with increasing levels of phosphorus.

Serum phosphorus levels between 3.5mg/dl and 6.2 mg/dl and were associated with a 55 per cent increased CVD risk, compared with levels of 1.6-2.8mg/dl. Serum calcium levels were not related to increased CVD events.

The researchers, led by Dr Ramachandran Vasan from the School of Medicine at Boston University, concluded that several mechanisms could explain the association of serum phosphorus levels with greater CVD risk.

Dr Richard Siow, of the King’s College London cardiovascular division, said: ‘The study implies that taking in phosphates in food  could increase the risk of CVD.’

But he said differences in males and females and different age groups should be assessed.

Further research is required to understand the mechanisms underlying the potential link between phosphorus homeostasis and vascular risk.

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