CVD Varies by Race in CKD Population
Researchers who studied a cohort of individuals with mild-to-moderate chronic kidney disease have identified racial differences in the prevalence of self-reported cardiovascular disease (CVD) and indicators of subclinical CVD.
Their study, which is described in the Clinical Journal of the American Society of Nephrology (2011;6:2121-2131), included 497 Hispanics, 1,638 non-Hispanic Caucasians, and 1,650 non-Hispanic African Americans who participated in the Chronic Renal Insufficiency Cohort (CRIC) study.
Findings showed that the prevalence of self-reported coronary artery disease and a coronary artery calcification (CAC) score above 100 were significantly lower among Hispanics than non-Hispanic Caucasians (18% vs. 23% and 34% and 41%), respectively. These differences became nonsignificant, however, after adjusting for sociodemographic factors. Hispanics were 2.5 times more likely than non-Hispanic African Americans to have a CAC score above 400.
The investigators noted that CAC scores above 100 and 400 are consistent with the presence of subclinical CVD based on previous studies suggesting that these cut-off points are associated with an increased risk of CVD events and all-cause mortality.
In addition, Hispanics were twice as likely as non-Hispanic Caucasians to report having left ventricular hypertrophy (LVH). Given the known relationship between hypertension and LVH, the authors noted, “this finding is likely best attributed to the higher rates of poor BP [blood pressure] control among Hispanics.”
“The health disparities found in our study are likely the result of a complex interplay among multiple factors at the individual and community levels, the health care system, and society as a whole,” the authors concluded.