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Nephropathy Risk Variants and Incident Cardiovascular Disease Events in Community-Dwelling Black Adults.

Title Nephropathy Risk Variants and Incident Cardiovascular Disease Events in Community-Dwelling Black Adults.
Publication TypeJournal Article
Year of Publication2018
AuthorsGutiérrez, OM, Irvin, MR, Chaudhary, NS, Cushman, M, Zakai, NA, David, VA, Limou, S, Pamir, N, Reiner, AP, Naik, RP, Sale, MM, Safford, MM, Hyacinth, HI, Judd, SE, Kopp, JB, Winkler, CA
JournalCirc Genom Precis Med
Volume11
Issue6
Paginatione002098
Date Published2018 Jun
ISSN2574-8300
Abstract

BACKGROUND: renal risk variants are strongly associated with chronic kidney disease in Black adults, but reported associations with cardiovascular disease (CVD) have been conflicting.METHODS: We examined associations of with incident coronary heart disease (n=323), ischemic stroke (n=331), and the composite CVD outcome (n=500) in 10 605 Black participants of the REGARDS study (Reasons for Geographic and Racial Differences in Stroke). Primary analyses compared individuals with high-risk genotypes to low-risk genotypes in Cox proportional hazards models adjusted for CVD risk factors and African ancestry.RESULTS: high-risk participants were younger and more likely to have albuminuria at baseline than low-risk participants. The risk of incident stroke, coronary heart disease, or composite CVD end point did not significantly differ by genotype status in multivariable models. The association of genotype with incident composite CVD differed by diabetes mellitus status (=0.004). In those without diabetes mellitus, high-risk genotypes associated with greater risk of incident composite CVD (hazard ratio, 1.67; 95% confidence interval, 1.12-2.47) compared with those with low-risk genotypes in multivariable adjusted models. This latter association was driven by ischemic strokes (hazard ratio, 2.32; 95% confidence interval, 1.33-4.07), in particular, those related to small vessel disease (hazard ratio, 5.10; 95% confidence interval, 1.55-16.56). There was no statistically significant association of genotypes with incident CVD in subjects with diabetes mellitus. The high-risk genotype was associated with higher stroke risk in individuals without but not those with chronic kidney disease in fully adjusted models.CONCLUSIONS: high-risk status is associated with CVD events in community-dwelling Black adults without diabetes mellitus.

DOI10.1161/CIRCGEN.117.002098
Alternate JournalCirc Genom Precis Med
PubMed ID29899045
Grant ListL60 MD013112 / MD / NIMHD NIH HHS / United States
R01 HL138423 / HL / NHLBI NIH HHS / United States