CVD Rates Higher in Black Patients With Diabetes, CKD

by U.S. Medicine

August 5, 2016

SEATTLE—Blacks have high rates of cardiovascular disease and mortality, as well as diabetes and chronic kidney disease, and risk factors for cardiovascular mortality in the general population are common among blacks.

A report published recently in the Clinical Journal of the American Journal of Nephrology sought to determine the connection between those factors.1

A study team led by researchers from the University of Washington and VA Puget Sound Healthcare system conducted an observational cohort study of 3,211 participants in the Jackson Heart Study (enrolled 2000-2004).

Rates of incident stroke, incident coronary heart disease and cardiovascular mortality were quantified in participants with diabetes, CKD (eGFR<60 ml/min per 1.73 m2, urine albumin-to-creatinine ratio ≥30 mg/g, or both), or both through 2012, with a median follow-up of 6.99 years.

Results indicate that 456 (14.2%) participants had only diabetes, 257 (8.0%) had only CKD, 201 (6.3%) had both, and 2297 (71.5%) had neither. Diabetes without CKD was associated with excess risks of incident stroke, incident coronary heart disease and cardiovascular mortality of 2.6, 2.6 and 2.4, respectively, per 1,000 person-years.

CKD without diabetes was associated with comparable nonsignificant excess risks for incident stroke and coronary heart disease of 2.5 and 2.4, respectively, but a larger excess risk for cardiovascular mortality of 7.3 per 1,000 person-years.

Diabetes and CKD together were associated with much greater excess risk for incident stroke or 13.8; coronary heart disease (12.8) and cardiovascular mortality (14.8).

“The excess risks associated with the combination of diabetes and CKD were larger than those associated with established risk factors, including prevalent cardiovascular disease,” study authors reported, adding, “The combination of diabetes and kidney disease is associated with substantial excess risks of cardiovascular events and mortality among blacks.”

1 Afkarian M, Katz R, Bansal N, Correa A, Kestenbaum B, Himmelfarb J, de Boer IH, Young B. Diabetes, Kidney Disease, and Cardiovascular Outcomes in the Jackson Heart Study. Clin J Am Soc Nephrol. 2016 Jun 23. pii: CJN.13111215. [Epub ahead of print] PubMed PMID: 27340284.

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