Abstract
Although . APOL1 high-risk genotype partially accounts for the increased susceptibility of blacks to chronic kidney disease (CKD), whether . APOL1 associates differentially with mortality risk remains controversial. Here we evaluate the association between . APOL1 genotype and risk of death and determine whether . APOL1 status modifies the association between strict versus usual blood pressure control and mortality risk. We performed a retrospective analysis of the African American Study of Kidney Disease and Hypertension trial that randomized black participants with CKD to strict versus usual blood pressure control from 1995 to 2001. This included 682 participants with known . APOL1 genotype (157 with high-risk genotype) previously assigned to either strict (mean arterial pressure [MAP] 92 mm Hg or less) versus usual blood pressure control (MAP 102-107 mm Hg) during the trial. During a median follow-up of 14.5 years, risk of death did not differ between individuals with high- versus low-risk . APOL1 genotypes (unadjusted hazard ratio 1.00 [95% confidence interval 0.76-1.33]). However, a significant interaction was detected between the . APOL1 risk group and blood pressure control strategy. In the . APOL1 high-risk group, the risk of death was 42% lower comparing strict versus usual blood pressure control (0.58 [0.35-0.97]). In the . APOL1 low-risk group, the risk of death comparing strict versus usual blood pressure control was not significantly different (1.09 [0.84-1.43]). Thus, strict blood pressure control during CKD associates with a lower risk of death in blacks with the high-risk CKD . APOL1 genotype. Knowledge of . APOL1 status could inform selection of blood pressure treatment targets in black CKD patients.
| Original language | English (US) |
|---|---|
| Journal | Kidney International |
| DOIs | |
| State | Accepted/In press - May 13 2016 |
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Keywords
- APOL1 genotype
- CKD
- Mortality
ASJC Scopus subject areas
- Medicine(all)
- Nephrology
Cite this
Strict blood pressure control associates with decreased mortality risk by APOL1 genotype. / Ku, Elaine; Lipkowitz, Michael S.; Appel, Lawrence; Parsa, Afshin; Gassman, Jennifer; Glidden, David V.; Smogorzewski, Miroslaw; Hsu, Chi yuan.
In: Kidney International, 13.05.2016.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Strict blood pressure control associates with decreased mortality risk by APOL1 genotype
AU - Ku, Elaine
AU - Lipkowitz, Michael S.
AU - Appel, Lawrence
AU - Parsa, Afshin
AU - Gassman, Jennifer
AU - Glidden, David V.
AU - Smogorzewski, Miroslaw
AU - Hsu, Chi yuan
PY - 2016/5/13
Y1 - 2016/5/13
N2 - Although . APOL1 high-risk genotype partially accounts for the increased susceptibility of blacks to chronic kidney disease (CKD), whether . APOL1 associates differentially with mortality risk remains controversial. Here we evaluate the association between . APOL1 genotype and risk of death and determine whether . APOL1 status modifies the association between strict versus usual blood pressure control and mortality risk. We performed a retrospective analysis of the African American Study of Kidney Disease and Hypertension trial that randomized black participants with CKD to strict versus usual blood pressure control from 1995 to 2001. This included 682 participants with known . APOL1 genotype (157 with high-risk genotype) previously assigned to either strict (mean arterial pressure [MAP] 92 mm Hg or less) versus usual blood pressure control (MAP 102-107 mm Hg) during the trial. During a median follow-up of 14.5 years, risk of death did not differ between individuals with high- versus low-risk . APOL1 genotypes (unadjusted hazard ratio 1.00 [95% confidence interval 0.76-1.33]). However, a significant interaction was detected between the . APOL1 risk group and blood pressure control strategy. In the . APOL1 high-risk group, the risk of death was 42% lower comparing strict versus usual blood pressure control (0.58 [0.35-0.97]). In the . APOL1 low-risk group, the risk of death comparing strict versus usual blood pressure control was not significantly different (1.09 [0.84-1.43]). Thus, strict blood pressure control during CKD associates with a lower risk of death in blacks with the high-risk CKD . APOL1 genotype. Knowledge of . APOL1 status could inform selection of blood pressure treatment targets in black CKD patients.
AB - Although . APOL1 high-risk genotype partially accounts for the increased susceptibility of blacks to chronic kidney disease (CKD), whether . APOL1 associates differentially with mortality risk remains controversial. Here we evaluate the association between . APOL1 genotype and risk of death and determine whether . APOL1 status modifies the association between strict versus usual blood pressure control and mortality risk. We performed a retrospective analysis of the African American Study of Kidney Disease and Hypertension trial that randomized black participants with CKD to strict versus usual blood pressure control from 1995 to 2001. This included 682 participants with known . APOL1 genotype (157 with high-risk genotype) previously assigned to either strict (mean arterial pressure [MAP] 92 mm Hg or less) versus usual blood pressure control (MAP 102-107 mm Hg) during the trial. During a median follow-up of 14.5 years, risk of death did not differ between individuals with high- versus low-risk . APOL1 genotypes (unadjusted hazard ratio 1.00 [95% confidence interval 0.76-1.33]). However, a significant interaction was detected between the . APOL1 risk group and blood pressure control strategy. In the . APOL1 high-risk group, the risk of death was 42% lower comparing strict versus usual blood pressure control (0.58 [0.35-0.97]). In the . APOL1 low-risk group, the risk of death comparing strict versus usual blood pressure control was not significantly different (1.09 [0.84-1.43]). Thus, strict blood pressure control during CKD associates with a lower risk of death in blacks with the high-risk CKD . APOL1 genotype. Knowledge of . APOL1 status could inform selection of blood pressure treatment targets in black CKD patients.
KW - APOL1 genotype
KW - CKD
KW - Mortality
UR - http://www.scopus.com/inward/record.url?scp=85008412694&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85008412694&partnerID=8YFLogxK
U2 - 10.1016/j.kint.2016.09.033
DO - 10.1016/j.kint.2016.09.033
M3 - Article
C2 - 27927600
AN - SCOPUS:85008412694
JO - Kidney International
JF - Kidney International
SN - 0085-2538
ER -