APOL1 Risk Variants and Cardiovascular Disease: Results from the AASK (African American Study of Kidney Disease and Hypertension)

Teresa K. Chen, Lawrence J. Appel, Morgan E. Grams, Adrienne Tin, Michael J. Choi, Michael S. Lipkowitz, Cheryl A. Winkler, Michelle M. Estrella

Research output: Contribution to journalArticlepeer-review

18 Scopus citations


Objective - Among African Americans, the apolipoprotein L1 (APOL1) risk variants have been associated with various types of kidney disease and chronic kidney disease progression. We aimed to determine whether these same risk variants also confer an increased risk for cardiovascular disease. Approach and Results - In a cohort of African Americans with hypertension-attributed chronic kidney disease followed for up to 12 years, we used Cox proportional hazards models to estimate the relative hazard of a composite cardiovascular disease outcome (cardiovascular death or hospitalization for myocardial infarction, cardiac revascularization procedure, heart failure, or stroke) for the APOL1 high- (2 risk variants) versus low-risk (0-1 risk variant) genotypes. We adjusted for age, sex, ancestry, smoking, heart disease history, body mass index, cholesterol, randomized treatment groups, and baseline and longitudinal estimated glomerular filtration rate, systolic blood pressure, and proteinuria. Among 693 participants with APOL1 genotyping available (23% high risk), the high-risk group had lower mean estimated glomerular filtration rate (44.7 versus 50.1 mL/min per 1.73 m2) and greater proteinuria (median 0.19 versus 0.06) compared with the low-risk group at baseline. There was no significant association between APOL1 genotypes and the composite cardiovascular disease outcome in both unadjusted (hazard ratio=1.23; 95% confidence interval: 0.83-1.81) and fully adjusted (hazard ratio=1.16; 95% confidence interval: 0.77-1.76) models; however, in using an additive model, APOL1 high-risk variants were associated with increased cardiovascular mortality. Conclusions - Among African Americans with hypertension-attributed chronic kidney disease, APOL1 risk variants were not associated with an overall risk for cardiovascular disease although some signals for cardiovascular mortality were noted.

Original languageEnglish (US)
Pages (from-to)1765-1769
Number of pages5
JournalArteriosclerosis, thrombosis, and vascular biology
Issue number9
StatePublished - Sep 1 2017


  • cardiovascular disease
  • coronary artery disease
  • heart failure
  • hypertension
  • myocardial infarction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


Dive into the research topics of 'APOL1 Risk Variants and Cardiovascular Disease: Results from the AASK (African American Study of Kidney Disease and Hypertension)'. Together they form a unique fingerprint.

Cite this