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November 21, 2024Journal of HypertensionOpen Access

Racial and regional disparities in the risk of noncommunicable disease between sub-Saharan black and European white patients

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Key result

Sub-Saharan Black patients exhibited a significantly worse cardiovascular and renal risk profile, including a higher prevalence of eGFR <60 ml/min/1.73 m2 (26.2% vs 7.7%), compared to European White patients despite being younger.

Why the study?

Greater vulnerability of Black versus White individuals to cardiovascular disease and chronic kidney disease is established in the United States, but studies involving sub-Saharan Blacks are scarce.

Do sub-Saharan Black patients have a higher risk of cardiovascular disease and chronic kidney disease compared to European White patients?

Population

168 sub-Saharan Blacks and 93 European Whites in an ongoing clinical trial

Comparison

Sub-Saharan Blacks vs European Whites

Design

Baseline cross-sectional analysis of clinical trial data

Authors

YYYu‐Ling YuDADe‐Wei AnBCBabangida S. Chori

Discussion

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Overview

Warrants earlier CKD screening in sub-Saharan Black patients; leaves open whether ethnicity-specific thresholds improve outcomes in prospective studies.

Key Points

  • To compare cardiovascular and chronic kidney disease risk profiles and urinary proteomic biomarkers between sub-Saharan Black individuals and European White individuals.
  • Analyzed baseline data (2021–2024) from an ongoing clinical trial (NCT04299529) including 168 sub-Saharan Black and 93 European White participants using standardized selection criteria.
  • Assessed clinical risk factors, Framingham CVD risk, KDIGO 2024 CKD classification, echocardiographic traits, and urinary proteomic scores (HF1 for left ventricular dysfunction and CKD273 for chronic kidney disease) via unadjusted and multivariable-adjusted models.
  • Despite younger average age (60.4 vs. 68.3 years), sub-Saharan Black participants had higher diabetes rates, higher BMI, faster heart rate, unfavorable cholesterol fractions, lower eGFR, microalbuminuria, and greater sedentary behavior.
  • Sub-Saharan Black individuals experienced significantly higher 10-year CVD risk, higher heart age, and more severe CKD grades.
  • Urinary CKD273 levels rose across advancing CKD stages in both cohorts, but levels of CKD273 and HF1 did not differ significantly by race.

Study Design

Type

Cross-Sectional (n=261)

Multicenter

Yes

Structured PICO

Do sub-Saharan Black patients have a higher risk of cardiovascular disease and chronic kidney disease compared to European White patients?

P
Population
261 asymptomatic adults aged 55-75 years with 5 or more cardiovascular risk factors, comprising sub-Saharan Blacks and European Whites, assessed at baseline for cardiovascular and chronic kidney disease risk.
E
Exposure
Sub-Saharan Black race/region (observational exposure)
C
Comparator
European White race/region
O
Outcome
Clinical and biochemical risk factors, Framingham CVD risk, CKD grades (KDIGO 2024), and urinary proteomic profiles predictive of left ventricular dysfunction (HF1) and CKD (CKD273)surrogate

Main Result

Absolute Event Rate: 26.2% vs 7.7%

p-value: p=<0.0001

Sub-Saharan Black patients exhibit a significantly worse cardiovascular and kidney disease risk profile at a younger age compared to European White patients, highlighting the need for targeted health policies.

Limitations

  • Did not differentiate host factors (genetic or molecular) from environmental drivers of ill health
  • 57 of 261 randomized patients did not fully comply with all entry criteria
  • Not all participants had urinary proteomic profiling (UPP) measurements
  • Asian participants were excluded from the current analysis due to small numbers
  • Study did not differentiate host (genetic, molecular, and pathogenic) from environmental drivers of disease.

Cite This Study

Yu et al. (2024) conducted a cross-sectional in High risk for cardiovascular disease and chronic kidney disease (n=261). Sub-Saharan Black race vs. European White race was evaluated on eGFR <60 ml/min/1.73 m2 (p=<0.0001). Sub-Saharan Black patients exhibited a significantly worse cardiovascular and renal risk profile, including a higher prevalence of eGFR <60 ml/min/1.73 m2 (26.2% vs 7.7%), compared to European White patients despite being younger.

synapsesocial.com/papers/6aa36da822af0bded4f42388https://doi.org/10.1097/hjh.0000000000003930
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Also Consider

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