In a large national study published in JAMA, higher levels of the urinary albumin-to-creatinine ratio was associated with greater risk of incident but not recurrent coronary heart disease (CHD) in black individuals when compared with white individuals.
Orlando M. Gutiérrez, MD, MMSc, of the University of Alabama at Birmingham, and colleagues conducted the study to determine whether the association of urinary albumin excretion with CHD events differs by race. It included black and white U.S. adults, 45 years and older, who were enrolled within the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study between 2003 and 2007 with follow-up through December 2009. The researchers examined race-stratified associations of urinary ACR in two groups: (1) incident CHD among 23,273 participants free of CHD at baseline; and (2) first recurrent CHD event among 4,934 participants with CHD at baseline.
Over a median 4.5 years of follow-up, a total of 616 incident CHD events (259 among black participants and 357 among white participants) were observed. Of these, 421 were nonfatal heart attacks and 195 were CHD-related deaths. Analysis of the data indicated that age- and sex-adjusted incidence rates increased in the higher categories of urinary ACR in both black and white participants. The adjusted incidence rates in the two highest categories of ACR were approximately 1.5-fold greater in black participants.
“In models adjusted for traditional cardiovascular risk factors and medications, higher baseline urinary ACR was associated with greater risk of incident CHD among black participants but not white participants,” the authors write. “Among those with CHD at baseline, fully adjusted associations of baseline urinary ACR with first recurrent CHD event were similar between black participants vs. white participants.” Read the study abstract.
