Monday, July 17, 2006 (Reuters Health)—Heart failure is predicted by renal dysfunction more strongly in blacks than whites, according to the latest findings of the Health, Aging, and Body Composition (Health ABC) study.

Dr. Kirsten Bibbins-Domingo of the University of California at San Francisco and colleagues in this multicenter study report on 1,124 blacks and 1,676 white community-dwelling older persons (between 70-79 years of age) who were free of heart failure at baseline.

After a mean of 5.7 years of follow-up, 200 participants developed heart failure, the investigators report in the July 10th issue of the Archives of Internal Medicine.

The main predictors were creatinine concentrations, high concentration of cystatin C and a low estimated glomerular filtration rate (eGFR). High cystatin C concentrations and low eGFR were associated with heart failure in all subjects, but the investigators found the magnitude was greatest in blacks and whites.

The hazard ratio of heart failure was 3.0 for the highest versus the lowest cystatin C concentration quintile in blacks compared with a hazard ratio of 1.4 in whites.

The hazard ratio was 2.7 for the lowest versus highest quintile of eGFR in blacks compared with a hazard ratio of 1.8 in whites.

Dr. Bibbins-Domingo's team says, "As cystatin C concentration detects a more linear gradient of risk for blacks compared with creatinine-based eGFR, measurement of cystatin C may lead to a better characterization of the risk (of heart failure) in blacks."