Abstract P300: Cardiovascular Risk Inequality in Subjects with Chronic Kidney Disease by Age, Race and Ethnicity in the United States
Objectives: Adults with chronic kidney disease (CKD) carry an extraordinarily excess risk for cardiovascular disease (CVD). The present study aimed to test two hypotheses: (1) Non-Hispanic black (NHB) with CKD have significantly higher CVD risk profiles than non-Hispanic white (NHW). (2) This difference significantly contributes to the excess risk of CVD in NHB versus NHW.
Methods: A total of 3,939 participants aged 21-74 years old in the baseline Chronic Renal Insufficiency Cohort Study, a multiethnic population-based study supported by the National Institute of Diabetes and Digestive and Kidney Diseases, were analyzed. CKD was classified using estimate glomerular filtration rate. A sum weighted CVDRisk score was developed from multiple CVD risk factors. Differences in CVDRisk score by race/ethnicity were tested using quantile regression (QR), a novel data mining approach to identify distribution of risk factors and outcomes.
Results: The prevalence of CVD was 30.7 and 38.2% in NHW and NHB with CKD (p<0.001). The means (SD) of CVDRisk score were 12.6 (5.7) in NHW and 14.6 (6.4) in NHB (p<0.001). QR analysis indicated that NHB had significantly higher CVDRisk score in all quantile (Qs) of CVDRisk score than NHW. This race/ethnicity difference was even worse among younger NHB (aged <65). An estimated 32% of the excess CVD prevalence for NHB versus NHW may be attributable to a higher CVDRisk score in those aged<65 years old.
Conclusion: The study highlights an excess and disproportionate distribution of CVD risk factor profile in subjects with CKD for NHB versus NHW. An estimated one third of the excess CVD prevalence in younger NHB with CKD could be explained by their higher CVD risk factor profiles.
Author Disclosures: L. Liu: None.
- © 2014 by American Heart Association, Inc.