Racial/ethnic differences in left ventricular structure and function in chronic kidney disease: The chronic renal insufficiency cohort

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, Lawrence J. Appel, Harold I. FeldmanAkinlolu Ojo, Mahboob Rahman, Raymond R. Townsend

*Corresponding author for this work

Research output: Contribution to journalArticle

5 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)822-829
Number of pages8
JournalAmerican Journal of Hypertension
Volume30
Issue number8
DOIs
StatePublished - 2017

Keywords

  • Blood pressure
  • Echocardiography
  • Hypertension
  • Left ventricular hypertrophy
  • Race and ethnicity
  • Remodeling
  • Renal insufficiency

ASJC Scopus subject areas

  • Internal Medicine

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    Ahmad, F. S., Cai, X., Kunkel, K., Ricardo, A. C., Lash, J. P., Raj, D. S., He, J., Anderson, A. H., Budoff, M. J., Nunes, J. A. W., Roy, J., Wright, J. T., Go, A. S., Sutton, M. G. S. J., Kusek, J. W., Isakova, T., Wolf, M., Keane, M. G., Appel, L. J., ... Townsend, R. R. (2017). Racial/ethnic differences in left ventricular structure and function in chronic kidney disease: The chronic renal insufficiency cohort. American Journal of Hypertension, 30(8), 822-829. https://doi.org/10.1093/ajh/hpx058