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Abstract: SA-OR014

Associations of Demographic and Clinical Comorbidities with Different PREVENT Risk Categories

Session Information

Category: CKD (Non-Dialysis)

  • 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Gregg, Lucile Parker, Baylor College of Medicine, Houston, Texas, United States
  • Chang, Ryan, Baylor College of Medicine, Houston, Texas, United States
  • Richardson, Peter, Baylor College of Medicine, Houston, Texas, United States
  • Walther, Carl P., Baylor College of Medicine, Houston, Texas, United States
  • Navaneethan, Sankar D., Baylor College of Medicine, Houston, Texas, United States
Background

The Predicting Risk of Cardiovascular Disease EVENTs (PREVENT) equations include eGFR to improve atherosclerotic cardiovascular disease (ASCVD) risk estimation. We assessed the associations of demographic and clinical characteristics with PREVENT risk categories among people with chronic kidney disease (CKD).

Methods

We identified U.S. veterans with incident CKD stages 3-4, defined as two eGFR values <60 mL/min/1.73 m2 ≥90 days apart, using data from the Veterans Health Administration from 2005-2022. We used the PREVENT ASCVD risk equation to estimate 10-year ASCVD risk at the time of incident CKD, categorized as low (<5%), borderline (5-7.4%), intermediate (7.5-19.9%), and high (≥20%) risk. Logistic regression assessed the associations of key demographic and clinical factors with different PREVENT risk categories, adjusted for age, sex, and race.

Results

We included 1,147,422 veterans with CKD and a calculable PREVENT risk score. Compared to White race, Black race was associated with lower odds of elevated ASCVD risk, while Other race was associated with higher odds of elevated risk categories (Figure). Hypertension was associated with an incrementally higher odds of borderline, intermediate, and high ASCVD risk. Angiotensin converting enzyme inhibitor (ACEi) and angiotensin receptor blocker (ARB) use was similarly associated with a stepwise increase in odds of higher risk categories. While glucagon-like peptide-1 (GLP-1) receptor agonist and sodium-glucose co-transporter 2 (SGLT2) inhibitor use were associated with higher risk categories, a similar graded increase in the strength of association with ASCVD risk was not noted (Figure).

Conclusion

Among veterans with CKD, these data suggest differential associations of race with ASCVD risk assessed by the PREVENT equation. We also report on the associations of hypertension and cardio-kidney protective medication use with ASCVD risk, suggesting the opportunity to improve these medications’ use in high-risk populations.

Funding

  • Other NIH Support

Digital Object Identifier (DOI)