Article Figures & Data
Figures
- Figure 1.
Prevalence of coronary artery calcium scores (0, 1 to 100, >100 to 400, >400) by race/ethnicity among participants with eGFR <30ml/min/1.73m2 (1a) and diabetes (1b). NH, non-Hispanic.
Tables
Demographic Characteristics Overall (n = 3785) Hispanic (n = 497) Non-Hispanic Caucasian (n = 1638) P1 Non-Hispanic African American (n = 1650) P2 Age, years 58.2 (11) 56.3 (12) 58.9 (11) <0.01 58.1 (11) <0.01 Gender, n (%) <0.01 Male 2076 (55) 288 (58) 982 (60) 0.43 806 (49) Female 1709 (45) 209 (42) 656 (40) 844 (51) Annual household income, n (%) <0.01 <0.01 <$20,000 1213 (32) 313 (63) 254 (16) 646 (39) $20,001–$50,000 925 (24) 92 (19) 416 (25) 417 (25) $50,001–$100,000 694 (18) 24 (5) 455 (28) 215 (13) >$100,000 369 (10) 12 (2) 295 (18) 62 (4) Missing 584 (15) 56 (11) 218 (13) 310 (9) Education, n (%) <0.01 <0.01 <7th grade 210 (6) 183 (37) 7 (0.4) 20 (1.2) 7th to 12th grade 610 (16) 110 (22) 83 (5) 417 (25) High school diploma 728 (19) 71 (14) 291 (18) 366 (22) Some college 1112 (29) 78 (16) 467 (29) 567 (34) College graduate 1125 (30) 55 (11) 790 (48) 280 (17) Health insurance, n (%) <0.01 <0.01 Yes 3085 (82) 322 (65) 1442 (88) 1321 (80) No 256 (7) 113 (23) 48 (3) 95 (6) Missing 444 (12) 62 (12) 148 (9) 234 (14) Ever seen a nephrologist 2503 (66) 265 (53) 1131 (69) <0.01 1107 (67) <0.01 Kidney function measures Serum creatinine, mg/dl 1.75 (0.6) 1.88 (0.6) 1.59 (0.5) <0.01 1.9 (0.6) 0.77 eGFR, ml/min/1.73 m2 42.8 (13) 37.5 (13) 43.7 (13) <0.01 43.5 (14) <0.01 eGFR categories, ml/min/1.73 m2, n (%) <30 734 (19) 151 (30) 278 (17) <0.01 305 (18) <0.01 30 to <40 939 (25) 162 (33) 389 (24) 388 (24) 40 to <50 999 (26) 107 (22) 462 (28) 430 (26) 50 to <60 722 (19) 51 (10) 349 (21) 322 (20) >60 391 (10) 26 (5) 160 (10) 205 (12) 24-hour urine protein, g, median (IQR) 0.18 (0.1–0.9) 0.72 (0.1–3.3) 0.12 (0.1–0.5) <0.01 0.24 (0.1–1.1) <0.01 Traditional cardiovascular risk factors Current cigarette smoker, n (%) 504 (13) 29 (6) 155 (9) 0.01 320 (19) <0.01 Hypertension, n (%) 3269 (86) 443 (89) 1293 (79) <0.01 1533 (93) 0.01 Systolic BP, mmHg 129 (22) 136 (24) 122 (19) <0.01 133 (23) 0.01a Diastolic BP, mmHg 72 (13) 73 (13) 69 (11) <0.01 74 (14) 0.07 Diabetes mellitus, n (%) 1831 (48) 334 (67) 649 (40) <0.01 848 (51) <0.01 Hemoglobin A1C 6.7 (2) 7 (2) 6.3 (1) <0.01 6.9 (2) 0.29 BMI, kg/m2 32 (8) 32 (7) 31 (8) 0.20 33 (8) <0.01 Total cholesterol, mg/dl 184 (45) 189 (54) 180 (42) <0.01a 186 (46) 0.14 LDL cholesterol, mg/dl 103 (36) 104 (40) 99 (32) 0.03a 106 (37) 0.24 HDL cholesterol, mg/dl 48 (15) 43 (13) 47 (15) <0.01 49 (16) <0.01 Family history of premature CHD, n (%) 603 (16) 50 (10) 322 (20) <0.01 231 (14) 0.02 Nontraditional cardiovascular risk factors Hemoglobin, g/dl 12.6 (2) 12.1 (2) 13.2 (2) <0.01 12.2 (2) 0.19 Serum calcium corrected for albumin,b mg/dl 9.2 (0.5) 9.2 (0.4) 9.2 (0.4) 0.56 9.3 (0.5) 0.01 Serum phosphorus, mg/dl 3.7 (0.7) 4 (0.7) 3.6 (0.6) <0.01 3.8 (0.7) <0.01 Total iPTH, pg/ml, median (IQR) 54 (35–90) 62 (41–102) 43 (30–69) <0.01a 67 (41–115) 0.09 hs-CRP, mg/dl, Median (IQR) 2.6 (1.1–6.6) 2.5 (1.0–5.7) 2.15 (0.9–5.2) 0.26 3.3 (1.3–8.2) <0.01 Values indicate mean (standard deviation) unless otherwise specified. eGFR, estimated glomerular filtration rate; hs-CRF, high-sensitivity C-reactive protein; IQR, interquartile range; P1, Hispanic versus Non-Hispanic Caucasian; P2, Hispanic versus Non-Hispanic African American.
a No longer significant after adjustment for age, gender, education, eGFR.
b Corrected calcium = Measured serum calcium + [0.8*(4–serum albumin)].
Variables Overall (n = 3785) Hispanic (n = 497) Non-Hispanic Caucasian (n = 1638) P1 Non-Hispanic African American (n = 1650) P2 Self-reported history of CVD Any CVD 1272 (34) 138 (28) 507 (31) 0.18 627 (38) <0.01 CHD (MI or coronary revascularization) 827 (22) 90 (18) 376 (23) 0.02 361 (22) 0.07 Heart failure 371 (10) 37 (7) 117 (7) 0.82 217 (13) <0.01 Stroke 382 (10) 37 (7) 118 (7) 0.86 227 (14) <0.01 Peripheral arterial disease 257 (7) 35 (7) 105 (6) 0.62 117 (7) 0.97 Subclinical Measures of CVD CAC score >100 719 (37) 115 (34) 359 (41) 0.03 245 (35) 0.88 CAC score >400 415 (22) 65 (19) 225 (26) 0.02 125 (18) 0.52 Left ventricular hypertrophy 1663 (54) 282 (71) 538 (40) <0.01 843 (63) <0.01 Ankle-brachial index <0.9 611 (16) 72 (15) 206 (13) 0.23 333 (20) <0.01 * Values indicate n (%) unless otherwise specified. CAC, coronary artery calcium score; IQR, interquartile range; P1, Hispanic versus non-Hispanic Caucasian; P2, Hispanic versus non-Hispanic African American.
- Table 3.
Clinical and subclinical measures of cardiovascular disease by estimated glomerular filtration rate (eGFR) in ml/min/1.73 m2*
eGFR, ml/min/1.73m2 Hispanic Non-Hispanic Caucasian P1 Non-Hispanic African American P2 Self-reported Cardiovascular Disease, n (%) <30 42 (28) 115 (41) <0.01 135 (44) <0.01 30 to <40 52 (32) 143 (37) 0.30 174 (45) <0.01 40 to <50 30 (28) 154 (33) 0.29 165 (38) 0.05 50 to <60 10 (20) 75 (21) 0.76 106 (33) 0.06 ≥60 4 (15) 20 (13) 0.68 47 (23) 0.38 Coronary artery calcium score >100, n (%) <30 32 (32) 61 (53) <0.01 47 (46) 0.05 30 to <40 43 (38) 91 (50) 0.05 43 (34) 0.44 40 to <50 26 (34) 99 (41) 0.25 69 (35) 0.80 50 to <60 11 (33) 83 (35) 0.81 59 (36) 0.75 ≥60 3 (18) 25 (23) 0.60 27 (22) 0.67 Coronary artery calcium score >400, n (%) <30 18 (18) 37 (32) 0.02 28 (27) 0.12 30 to <40 24 (21) 61 (34) 0.03 27 (21) 0.95 40 to <50 14 (18) 61 (25) 0.20 31 (16) 0.65 50 to <60 7 (21) 52 (22) 0.90 27 (17) 0.52 ≥60 2 (12) 14 (13) 0.88 12 (10) 0.80 Left ventricular hypertrophy, n (%) <30 104 (83) 121 (54) <0.01 182 (76) 0.14 30 to <40 90 (70) 139 (45) <0.01 223 (69) 0.72 40 to <50 57 (63) 151 (40) <0.01 219 (63) 0.92 50 to <60 24 (65) 93 (31) <0.01 141 (54) 0.20 ≥60 7 (37) 34 (25) 0.26 78 (45) 0.48 Ankle-brachial index <0.9, n (%) <30 35 (24) 53 (20) 0.30 86 (28) 0.31 30 to <40 23 (15) 68 (18) 0.37 84 (22) 0.05 40 to <50 5 (5) 51 (11) 0.05 88 (21) <0.01 50 to <60 7 (14) 32 (9) 0.26 62 (19) 0.39 ≥60 2 (8) 2 (1) 0.04 13 (7) 0.82 * Values indicate n (%). P1, Hispanic versus non-Hispanic Caucasian; P2, Hispanic versus non-Hispanic African American.
- Table 4.
Crude and adjusted odds ratio (OR) of clinical and subclinical measures of cardiovascular disease (CVD)
Variables Any self-reported CVD CAC >100 CAC >400 LVH ABI <0.9 OR (95% CI) P value OR (95% CI) P value OR (95% CI) P value OR (95% CI) P value OR (95% CI) P value Unadjusted Hispanic versus NH Caucasian 0.86 (0.69, 1.07) 0.18 0.75 (0.58, 0.97) 0.03 0.69 (0.51, 0.94) 0.02 3.64 (2.86, 4.63) <0.01 1.19 (0.89, 1.60) 0.23 Hispanic versus NH African American 0.63 (0.50, 0.78) <0.01 0.98 (0.74, 1.29) 0.88 1.11 (0.80, 1.55) 0.52 1.44 (1.13, 1.83) <0.01 0.68 (0.52, 0.90) <0.01 Adjusted for demographic characteristicsa Hispanic versus NH Caucasian 1.10 (0.75, 1.62) 0.63 0.89 (0.47, 1.69) 0.73 1.12 (0.56, 2.24) 0.74 2.16 (1.42, 3.27) <0.01 1.26 (0.79, 2.03) 0.33 Hispanic versus NH African American 0.88 (0.61, 1.28) 0.51 1.45 (0.77, 2.74) 0.25 2.34 (1.17, 4.68) 0.02 1.08 (0.71, 1.62) 0.72 0.88 (0.56, 1.39) 0.60 Adjusted for demographic and clinical characteristicsb Hispanic versus NH Caucasian 1.03 (0.68, 1.55) 0.90 0.63 (0.30, 1.33) 0.23 0.86 (0.39, 1.93) 0.72 1.97 (1.22, 3.17) <0.01 1.29 (0.78, 2.13) 0.32 Hispanic versus NH African American 0.82 (0.55, 1.23) 0.34 1.35 (0.64, 2.82) 0.43 2.49 (1.11, 5.58) 0.03 1.44 (0.90, 2.31) 0.13 1.05 (0.65, 1.70) 0.84 Age 1.06 (1.05, 1.07) <0.01 1.10 (1.08, 1.11) <0.01 1.09 (1.07, 1.11) <0.01 1.03 (1.02, 1.04) <0.01 1.05 (1.04, 1.07) <0.01 Gender (female versus male) 0.66 (0.54, 0.79) <0.01 0.32 (0.24, 0.42) <0.01 0.36 (0.26, 0.50) <0.01 0.86 (0.70, 1.06) 0.15 1.03 (0.81, 1.29) 0.83 Education <7th grade versus college graduate 1.20 (0.75, 1.91) 0.45 0.72 (0.37, 1.40) 0.30 0.83 (0.39, 1.73) 0.61 2.50 (1.37, 4.53) <0.01 1.12 (0.63, 1.99) 0.70 7th to 12th grade versus college graduate 1.23 (0.94, 1.60) 0.13 1.18 (0.75, 1.84) 0.50 1.47 (0.90, 2.40) 0.13 1.70 (1.24, 2.33) <0.01 1.49 (1.07, 2.08) 0.02 HS diploma versus college graduate 1.29 (1.01, 1.64) 0.04 1.37 (0.94, 1.98) 0.10 1.58 (1.05, 2.38) 0.03 1.44 (1.10, 1.88) <0.01 1.54 (1.13, 2.09) <0.01 Some college versus college graduate 1.38 (1.12, 1.71) <0.01 1.18 (0.86, 1.62) 0.30 1.05 (0.73, 1.50) 0.80 1.35 (1.07, 1.70) 0.01 1.34 (1.00, 1.78) 0.05 eGFR (10 ml/min/1.73 m2 increase) 0.90 (0.84, 0.97) <0.01 0.89 (0.79, 1.00) 0.05 0.95 (0.82, 1.09) 0.45 0.86 (0.79, 0.93) 0.02 0.78 (0.71, 0.86) <0.01 Proteinuria (natural log) 1.08 (1.01, 1.15) 0.02 1.03 (0.93, 1.13) 0.58 1.06 (0.95, 1.18) 0.28 1.17 (1.09, 1.26) <0.01 0.95 (0.88, 1.02) 0.17 Diabetes (yes versus no) 1.63 (1.37, 1.95) <0.01 2.67 (2.02, 3.51) <0.01 2.08 (1.52, 2.83) <0.01 1.03 (0.84, 1.25) 0.81 1.76 (1.40, 2.21) <0.01 Hyperlipidemia (yes versus no) 2.26 (1.76, 2.90) <0.01 1.69 (1.21, 2.37) <0.01 1.93 (1.25, 2.97) <0.01 1.09 (0.86, 1.39) 0.48 2.04 (1.46, 2.84) <0.01 BMI 1.01 (1.00, 1.02) 0.29 1.01 (0.99, 1.03) 0.47 1.00 (0.98, 1.02) 0.95 1.15 (1.13, 1.17) <0.01 1.00 (0.99, 1.02) 0.77 Systolic BP (10-mmHg increase) 1.01 (0.97, 1.05) 0.80 1.07 (1.00, 1.14) 0.05 1.05 (0.97, 1.12) 0.23 1.21 (1.15, 1.28) <0.01 1.06 (1.01, 1.12) 0.02 Current smoker (yes versus no) 1.33 (1.06, 1.69) 0.02 1.56 (1.03, 2.35) 0.03 1.43 (0.90, 2.28) 0.13 1.43 (1.09, 1.89) 0.01 2.19 (1.67, 2.88) <0.01 Family history of premature CHD 1.80 (1.46, 2.20) <0.01 1.84 (1.33, 2.56) <0.01 1.91 (1.34, 2.73) <0.01 1.27 (0.99, 1.62) 0.06 1.16 (0.90,1.51) 0.25 Serum hemoglobin 0.96 (0.91, 1.01) 0.14 0.91 (0.83, 0.99) 0.03 0.87 (0.79, 0.95) <0.01 0.87 (0.82, 0.93) <0.01 0.97 (0.91, 1.04) 0.45 hs-CRP (1 SD) 1.03 (0.96, 1.12) 0.40 1.00 (0.85, 1.16) 0.95 0.97 (0.81, 1.16) 0.71 1.00 (0.91, 1.09) 0.92 1.12 (1.03, 1.22) <0.01 Serum phosphate 1.06 (0.93, 1.22) 0.37 1.35 (1.09, 1.66) <0.01 1.41 (1.21, 1.78) <0.01 — — 1.08 (0.91, 1.27) 0.39 Corrected serum calcium 1.03 (0.86, 1.22) 0.79 1.04 (0.79, 1.38) 0.76 0.95 (0.70, 1.31) 0.77 — — 0.93 (0.75, 1.15) 0.51 Total iPTH — — 1.00 (1.00, 1.00) 0.43 1.00 (1.00, 1.00) 0.63 — — — — CAC, coronary artery calcium; CVD, cardiovascular disease; LVH, left ventricular hypertrophy; ABI, ankle-brachial index; CI, confidence interval; OR, odds ratio; NH, non-Hispanic; eGFR, estimated glomerular filtration rate; HS, high school; BP, blood pressure; Hs-CRP, high-sensitivity C-reactive protein; SD, standard deviation; iPTH, intact parathyroid hormone; BMI, body mass index.
a Adjusted for age, gender, education, and clinical site.
b Additionally adjusted for all variables listed. CVD, CAC, and ABI models were additionally adjusted for serum phosphate and calcium. Intact PTH (iPTH) was only analyzed in the CAC models.
- Table 5.
Achievement of guideline-recommended goals for secondary prevention of CVD among participants with any self-reported CVD at baseline
Variables Hispanic n = 138 Non-Hispanic Caucasian n = 507 Non-Hispanic African American n = 627 n (%) n (%) P n (%) P Not current smoker 132 (96) 454 (90) 0.03 488 (78) <0.01 BP <130/80 mmHG 55 (40) 316 (62) <0.01 244 (39) 0.84 LDL ≤100 101 (73) 361 (71) 0.65 352 (56) <0.01 Physical activity 30 min/day, at least 5 d/wk 51 (39) 257 (53) <0.01 259 (44) 0.23 BMI <25 kg/m2 13 (9) 74 (15) 0.12 76 (12) 0.37 Waist circumference: men <40 in, women <35 in 47 (35) 154 (31) 0.35 138 (22) <0.01 Hg A1C <7% 54 (39) 313 (62) <0.01 333 (53) <0.01 Aspirin use 66 (48) 343 (68) <0.01 363 (58) 0.03 RAS blocker use 100 (73) 397 (79) 0.13 479 (77) 0.30 β-blocker use 104 (76) 346 (69) 0.11 452 (73) 0.40 BMI, body mass index; Hg, hemoglobin; RAS, renin-angiotensin system.
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