Cardiovascular Disease Risk Estimates in the US CKD Population Using the PREVENT Equation

Area of Science:

• Cardiology
• Nephrology
• Epidemiology

Background:

• Cardiovascular disease (CVD) risk prediction is crucial for prevention.
• Traditional risk equations often neglect kidney function.
• The 2023 AHA PREVENT equations incorporate kidney measures (eGFR, UACR).

Purpose of the Study:

• To estimate CVD risk in the US chronic kidney disease (CKD) population using the 2023 AHA PREVENT equations.
• To compare PREVENT equation risk estimates with the 2013 AHA/ACC pooled cohort equations (PCEs).

Main Methods:

• Cross-sectional study using National Health and Nutrition Examination Survey (NHANES) data (2013-2020).
• Included individuals aged 40-75 years with CKD (eGFR<60 or UACR≥30) without prior CVD.
• Utilized survey methods to represent the US CKD population.

Main Results:

• PREVENT equations estimated lower 10-year atherosclerotic CVD (ASCVD) risk (8.8%) compared to PCEs (by 5.2 percentage points).
• Mean 10-year heart failure risk was 11.6% and CVD risk was 15.3%.
• 63.4% (AHA guideline) to 85.9% (KDIGO guideline) of CKD patients were eligible for statin therapy, but less than half were receiving it.

Conclusions:

• The PREVENT equations provide lower ASCVD risk estimates for CKD patients compared to PCEs.
• A significant gap exists in statin therapy uptake among eligible CKD patients.
• This highlights a critical opportunity for CVD prevention in the CKD population.