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Abstract: TH-OR24

Sex Difference in Cardiovascular Risk in Non-CKD and CKD: NHANES 1999-2018

Session Information

Category: Hypertension and CVD

  • 1501 Hypertension and CVD: Epidemiology‚ Risk Factors‚ and Prevention


  • Oh, Ester, University of Colorado - Anschutz Medical Campus, Aurora, Colorado, United States
  • You, Zhiying, University of Colorado - Anschutz Medical Campus, Aurora, Colorado, United States
  • Nowak, Kristen L., University of Colorado - Anschutz Medical Campus, Aurora, Colorado, United States
  • Jovanovich, Anna, University of Colorado - Anschutz Medical Campus, Aurora, Colorado, United States

In the general population, females (vs. males) have a lower risk for cardiovascular disease (CVD). However, little is known whether this sex-specific risk pattern of CVD translates to individuals with chronic kidney disease (CKD). The purpose of this study was to examine if there was a sex-specific risk of CVD in adults who participated in the National Health and Nutrition Examination Survey (NHANES), both with CKD and without CKD.


Multivariable logistic regression models were used to examine the odds ratio (OR) for 1) self-reported CVD, including myocardial infarction, stroke, angina pectoris, and congestive heart failure, in females vs. males in non-CKD (18-75 y and ≥55 y) and stage 3-4 CKD sub-groups (18-75 y) and 2) Atherosclerotic Cardiovascular Disease (ASCVD) risk score in non-CKD (18-75 y and ≥55 y) vs. CKD (18-75 y), separately for males and females.


Adults with CKD (n=1,347; 52% F; 64±9 y; estimated glomerular filtration rate [eGFR] 47±10 ml/min/1.73m2) and without CKD (n=38,858; 51% F; 43±16 y; eGFR 102±18 ml/min/1.73m2) were included in the study. In order to better match the mean age between the non-CKD and CKD sub-groups, adults without CKD were further sub-grouped into those ≥55 y (n=11,117; 50% F; 64±5 y; eGFR 87±13 ml/min/1.73m2). Females had a lower fully adjusted odds for CVD than males in the 18-75 y and ≥55 y non-CKD (Fig. 1A). However, in adults 18-75 y with CKD, there was no sex difference in fully adjusted odds for CVD. As compared to females ≥55 y without CKD, females 18-75 y with CKD had a higher odds of intermediate-high vs. low-borderline ASCVD risk score in the fully adjusted model (Fig. 1B). No difference was observed in the OR of a higher ASCVD score between CKD males 18-75 y vs. non-CKD males ≥55 y.


Our findings suggest that CKD abolishes the cardiovascular protection observed in females without CKD. In addition, CKD may be a stronger risk factor for CVD in females than males.

Sex difference in self-reported CVD in non-CKD and CKD (A) and ASCVD risk score in in non-CKD vs. CKD by sex (B).


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