Racial/Ethnic Differences in Left Ventricular Structure and Function in Chronic Kidney Disease: The Chronic Renal Insufficiency Cohort
Year: 2017
Type: article
Abstract: BACKGROUND: Chronic kidney disease (CKD) is associated with increased risk of cardiovascular disease (CVD) and it is especially common among Blacks. Left ventricular hypertrophy (LVH) is an important subclinical marker of CVD, but there are limited data on racial variation in left ventricular structure and function among persons with CKD. METHODS: In a cross-sectional analysis of the Chronic Renal Insufficiency Cohort Study, we compared the prevalence of different types of left ventricular remodeling (concentric hypertrophy, eccentric hypertrophy, and concentric remodeling) by race/ethnicity. We used multinomial logistic regression to test whether race/ethnicity associated with different types of left ventricular remodeling independently of potential confounding factors. RESULTS: We identified 1,164 non-Hispanic Black and 1,155 non-Hispanic White participants who completed Year 1 visits with echocardiograms that had sufficient data to categorize left ventricular geometry type. Compared to non-Hispanic Whites, non-Hispanic Blacks had higher mean left ventricular mass index (54.7 ± 14.6 vs. 47.4 ± 12.2 g/m2.7; P < 0.0001) and prevalence of concentric LVH (45.8% vs. 24.9%). In addition to higher systolic blood pressure and treatment with >3 antihypertensive medications, Black race/ethnicity was independently associated with higher odds of concentric LVH compared to White race/ethnicity (odds ratio: 2.73; 95% confidence interval: 2.02, 3.69). CONCLUSION: In a large, diverse cohort with CKD, we found significant differences in left ventricular mass and hypertrophic morphology between non-Hispanic Blacks and Whites. Future studies will evaluate whether higher prevalence of LVH contribute to racial/ethnic disparities in cardiovascular outcomes among CKD patients.
Source: American Journal of Hypertension
DOI: 10.1093/ajh/hpx058
Authors: Faraz S. Ahmad, Xuan Cai, Katherine Kunkel, Ana C. Ricardo, James P. Lash, Dominic S. Raj, Jiang He, Amanda H. Anderson, Matthew J. Budoff, Julie A. Wright Nunes, Jason Roy, Jackson T. Wright, Alan S. Go, Martin G. St. John Sutton, John W. Kusek, Tamara Isakova, Myles Wolf, Martin G. Keane, the CRIC Study Investigators
Institutions: Northwestern University, University of Pennsylvania, University of Illinois Chicago, George Washington University, Tulane University, The Lundquist Institute, University of Michigan, Case Western Reserve University, Kaiser Permanente, University of California, San Francisco, Stanford Medicine, Kaiser Permanente Northern California, Stanford University, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Duke University, Duke Medical Center, Temple University
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funders: Johns Hopkins University, University of Maryland, National Institutes of Health, Perelman School of Medicine, University of Pennsylvania, Michigan Institute for Clinical and Health Research, University of Illinois at Chicago, National Heart, Lung, and Blood Institute, National Institute of General Medical Sciences, National Institute of Diabetes and Digestive and Kidney Diseases, National Center for Research Resources, National Center for Advancing Translational Sciences
Awards: Clinical and Translational Science Institute, G1668154545, G1710642513, Role of FGF23 in Mineral Metabolism Across the Spectrum of Chronic Kidney Disease, Continuation of the Chronic Renal Insufficiency Cohort (CRIC) Study, Non-Traditional Patient Characteristics and Attainment of Self-Care Goals in CKD, General Clinical Research Center, Mentored Patient Oriented Research in Mineral Metabolism, G37449730, Gender Disparities and Vascular Function in Chronic Kidney Disease Outcomes, FGF23 and Cardiovascular Disease in CKD, Center for Clinical and Translational Science, Michigan Institute for Clinical and Health Research (MCHR), Institute for Clinical and Translational Research, Institutional Clinical and Translational Science Award, G7958222963, Clinical and Translational Science Collaborative of Cleveland, G8579968195, Research Training in CVD Epidemiology and Prevention, Tulane COBRE for Clinical and Translational Research in Cardiometabolic Diseases, Prospective renal insufficiency cohort evaluation: PRICE, Chronic Renal Insufficiency Cohort (CRIC) Study Clinical Center, Continuation of the University of Illinois Chicago CRIC Clinical Center, Limited Competition for the Continuation of the Chronic Renal Insufficiency Cohort (CRIC) Hopkins Clinical Center, Tulane Clinical Center for Chronic Renal Insufficiency Cohort Study, Chronic Renal Insufficiency Cohort Limited competition continuation, Chronic Renal Insufficiency Cohort (CRIC) Study
OpenAlex ID: W2609880429