Cardiovascular Risk Factor Profiles and Disease in Black Compared to Other Africans with Chronic Kidney Disease.

ABSTRACT:

Methods

Cardiovascular risk factors, aortic and cardiac function, atherosclerosis extent, and cardiovascular event rates were assessed in 115 consecutive predialysis (n?=?67) and dialysis patients (n?=?48) including 46 black and 69 other (32 Asian, 28 white, and 9 mixed race) participants. Data were analysed in multivariable regression models.

Results

Overall, black compared to other African CKD patients had less frequent carotid artery plaque (OR (95% CI)?=?0.38 (0.16-0.91)) despite an increased cardiovascular risk factor burden. In receiver operator characteristic curve analysis, the Framingham score performed well in identifying non-black but not black CKD patients with carotid plaque (area under the curve (AUC) (95% CI)?=?0.818 (0.714-0.921) and AUC (95% CI)?=?0.556 (0.375-0.921), respectively). Black compared to other African predialysis patients experienced larger Framingham scores and more adverse nontraditional cardiovascular risk factors, impaired arterial and diastolic function but similar cardiovascular event rates (OR (95% CI)?=?0.93 (0.22 to 3.87)). Among dialysis patients, black compared to other Africans had an overall similar traditional and nontraditional cardiovascular risk factor burden, similar arterial and diastolic function but increased systolic function (partial R?=?0.356, p?=?0.01 and partial R?=?0.315, p?=?0.03 for ejection fraction and stroke volume, respectively) and reduced cardiovascular event rates (OR (95% CI)?=?0.22 (0.05 to 0.88)).

Conclusion

Black compared to other African CKD patients have less frequent very high risk atherosclerosis and experience weaker cardiovascular risk factor-atherosclerotic CVD relationships. These disparities may be due to differences in epidemiological health transition stages. Among dialysis patients, black compared to other Africans have less cardiovascular events, which may represent a selection bias as previously documented in black Americans.

SUBMITTER: Hsu HC 

PROVIDER: S-EPMC7929676 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature