Abstract
Ethnicity appears to play an important role in the prevalence and severity of hypertension, renal disease, and atherosclerosis. A cross-sectional study was conducted, including 206 Afro-descendants with hypertension, living in the remaining quilombo communities. These subjects underwent a carotid intima-media thickness (CIMT) assessment. The presence of renal injury was assessed by: (1) The glomerular filtration rate (GFR) estimated by the formula CKD-EPI using creatinine and cystatin C and (2) Albuminuria (ACR ≥30 mg/g). The Poisson distribution model was set with robust variance to identify factors associated with carotid atherosclerosis. The statistical analysis was performed using the Stata 12.0 software, adopting a significance level of 5%. Most subjects were women (61.65%); the average age was 61.32 (±12.44) years. Subjects (12.62%) were identified with GFR <60 mL/min/1.73 m2 and 22.8% with albuminuria. Patients (59.22%) presented with a high CIMT. In the adjusted regression model, age ≥60 years (PR: 1.232 [CI 95%:1.091–1.390], p value = .001), ACR ≥30 mg/g (PR: 1.176 [CI 95%: 1.007–1.373], p = .040), and GFR/CKD-EPI using cystatin C (PR: 1.250 [CI 95%: 1.004–1.557], p = .045) were independently associated with carotid atherosclerosis. The occurrence of atherosclerotic lesions was high in the studied group. Age, albuminuria, and GFR (estimated by the formula CKD-EPI using cystatin C) influenced the prevalence of carotid atherosclerosis.
Highlights
Cardiovascular diseases have been historically considered as diseases of the developed countries
This study aims to investigate the influence of renal disease markers on the prevalence of carotid atherosclerotic disease among African-American residents in the remaining quilombo communities in the northern state of Maranh~ao, Brazil
It aimed to evaluate the association of renal disease markers with carotid atherosclerosis, and identified a high prevalence of carotid intima-media thickness (CIMT) (59.22%), for which the independently associated factors are age, albuminuria, and reduced glomerular filtration rate estimated by the CKD-EPI formula, using cystatin C as a serum marker
Summary
Cardiovascular diseases have been historically considered as diseases of the developed countries. These disorders are rapidly contributing to an increased morbidity in the developing regions with varied racial/ ethnic groups [1,2]. Williams et al [7] studied the relationship between aggression and subclinical carotid atherosclerosis in 14,098 subjects of the Atherosclerosis Risk in Communities Study (ARIC) cohort. They observed that the carotid intima-media thickness (CIMT) was greater in Black men with an aggressive profile, when compared to other sexes and ethnicity groups. In a cardiovascular health study, which evaluated 4926 White Caucasian subjects and 244 Black subjects of both sexes, aged 65 years or over, it was found that the CIMT was significantly greater in the Black population when compared to the White population, even after adjusting for cardiovascular risk factors [8]
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