Racial/Ethnic Differences in Left Ventricular Structure and Function in Chronic Kidney Disease: The Chronic Renal Insufficiency Cohort.

Published

Journal Article

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.

Full Text

Duke Authors

Cited Authors

  • Ahmad, FS; Cai, X; Kunkel, K; Ricardo, AC; Lash, JP; Raj, DS; He, J; Anderson, AH; Budoff, MJ; Wright Nunes, JA; Roy, J; Wright, JT; Go, AS; St John Sutton, MG; Kusek, JW; Isakova, T; Wolf, M; Keane, MG; CRIC Study Investigators,

Published Date

  • August 1, 2017

Published In

Volume / Issue

  • 30 / 8

Start / End Page

  • 822 - 829

PubMed ID

  • 28444108

Pubmed Central ID

  • 28444108

Electronic International Standard Serial Number (EISSN)

  • 1941-7225

Digital Object Identifier (DOI)

  • 10.1093/ajh/hpx058

Language

  • eng

Conference Location

  • United States