학술논문

Racial/Ethnic Differences in Left Ventricular Structure and Function in Chronic Kidney Disease: The Chronic Renal Insufficiency Cohort.
Document Type
article
Source
American Journal of Hypertension. 30(8)
Subject
Hypertension
Prevention
Clinical Research
Cardiovascular
Kidney Disease
Renal and urogenital
Good Health and Well Being
Adult
Aged
Blacks
Blood Pressure
Cohort Studies
Cross-Sectional Studies
Electrocardiography
Ethnicity
Female
Heart Ventricles
Humans
Hypertrophy
Left Ventricular
Male
Middle Aged
Prevalence
Renal Insufficiency
Chronic
Socioeconomic Factors
Ventricular Dysfunction
Left
Ventricular Remodeling
Whites
Young Adult
blood pressure
echocardiography
hypertension
left ventricular hypertrophy
race and ethnicity
remodeling
renal insufficiency
CRIC Study Investigators
White People
Black People
Clinical Sciences
Cardiovascular System & Hematology
Language
Abstract
BackgroundChronic 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.MethodsIn 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.ResultsWe 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).ConclusionIn 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.