J Natl Med Assoc
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Relatively high serum albumin levels compared to low levels have been associated with reduced cardiovascular mortality and coronary heart disease and stroke incidence. The nature of these associations remains undefined. Therefore, widely accepted criteria of Bradford Hill were used to assess the likelihood that the association is a causal one. ⋯ Favoring a causal association are lack of temporal ambiguity in cohort studies, consistency of findings among studies and biologically plausible mechanisms. Not favoring a causal association are lack of specificity of the association, and inconsistency among age-, sex-groups. Further studies are needed to elucidate mechanisms for the effect of serum albumin on incidence of cardiovascular disease and death.