{"doi":"10.1001/jamanetworkopen.2022.7559","title":"Carotid Atherosclerosis, Microalbuminuria, and Estimated 10-Year Atherosclerotic Cardiovascular Disease Risk in Sub-Saharan Africa","abstract":"Importance: Carotid atherosclerosis and microalbuminuria are associated with atherosclerotic cardiovascular disease (ASCVD) but are understudied in sub-Saharan Africa. Objective: To evaluate the association of carotid atherosclerosis and microalbuminuria with 10-year ASCVD risk in middle-aged sub-Saharan African individuals. Design, Setting, and Participants: This cross-sectional study conducted analyses of baseline data from the African-Wits-INDEPTH (International Network for the Demographic Evaluation of Populations and Their Health in Low- and Middle-Income Countries) genomic study (AWI-Gen). Women and men aged 40 to 60 years without baseline CVD and drawn from Burkina Faso, Ghana, Kenya, and South Africa were included. Main Outcomes and Measures: Hypotheses for the analyses were formulated after data collection. The main exposures were carotid atherosclerosis, assessed using carotid intima-media thickness (CIMT) using B-mode ultrasonography, and microalbuminuria, measured using spot urine albumin (SUA) and urine albumin-creatinine ratio (uACR). The main outcome was high ASCVD risk, defined as a 2018 Pooled Cohort Equations score of 7.5% or greater. Associations were estimated using adjusted multivariable logistic regression analyses. Findings: A total of 9010 participants with a mean (SD) age of 50 (6) years and 4533 (50.3%) women were included. High CIMT, SUA, and uACR were each associated with older age (eg, mean [SD] age of participants with high vs reference range CIMT: 55 [5] years vs 50 [6] years; P < .001) and high prevalence of both diabetes and hypertension (eg, hypertension among those with high vs reference range SUA: 213 of 1117 [19.1%] vs 356 of 2549 [14.0%]; P < .001). Smokers were likely to have higher vs reference range SUA (210 [18.8%] vs 407 [16.0%]) and uACR (138 of 707 [19.5%] vs 456 of 2797 [16.3%]). Carotid atherosclerosis was common in Burkina Faso (82 of 262 [31.3%]) and Ghana (91 [34.7%]), while microalbuminuria, measured by SUA, was common in Kenya (272 [24.4%]) and South Africa (519 [46.5%]). SUA was associated with higher odds of carotid atherosclerosis (odds ratio [OR], 1.77; 95% CI, 1.04-3.01) compared with uACR (OR, 0.51; 95% CI, 0.27-0.95). Common CIMT, SUA, and uACR were associated with 10-year ASCVD risk, with CIMT having a stronger association with 10-year ASCVD risk in both women (OR, 1.95; 95% CI, 1.78-2.14) and men (OR, 1.73; 95% CI, 1.55-1.93) than SUA (women: OR, 1.29; 95% CI, 1.12-1.43; men: OR, 1.46; 95% CI, 1.26-1.55) and uACR (women: OR, 1.32; 95% CI, 1.10-1.54; men: OR, 1.35; 95% CI, 1.15-1.46). Conclusions and Relevance: The presence of microalbuminuria measured by SUA may indicate risk of subclinical carotid atherosclerosis and high 10-year ASCVD risk in middle-aged residents of sub-Saharan Africa. These data should be confirmed in longitudinal studies of cardiovascular events.","journal":"JAMA Network Open","year":2022,"id":251761,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":24,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.7301,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":377297,"name":"Daniel Boateng","orcid":"0000-0001-7568-7298","position":1,"is_corresponding":false},{"id":444302,"name":"Nigel J. Crowther","orcid":"0000-0002-5766-1745","position":2,"is_corresponding":false},{"id":339813,"name":"Kerstin Klipstein‐Grobusch","orcid":"0000-0002-5462-9889","position":3,"is_corresponding":false},{"id":231137,"name":"Abraham Oduro","orcid":"0000-0002-4191-7419","position":4,"is_corresponding":false},{"id":231136,"name":"Godfred Agongo","orcid":"0000-0002-4218-5424","position":5,"is_corresponding":false},{"id":568992,"name":"Shukri F. Mohamed","orcid":"0000-0002-8693-1943","position":6,"is_corresponding":false},{"id":368793,"name":"Palwendé Romuald Boua","orcid":"0000-0001-8325-2665","position":7,"is_corresponding":false},{"id":568993,"name":"Solomon Choma","orcid":"0000-0003-1338-6523","position":8,"is_corresponding":false},{"id":298901,"name":"Shane A. Norris","orcid":"0000-0001-7124-3788","position":9,"is_corresponding":false},{"id":443314,"name":"Stephen Tollman","orcid":"0000-0003-0744-7588","position":10,"is_corresponding":false},{"id":489064,"name":"Michiel L. Bots","orcid":"0000-0003-2871-9810","position":11,"is_corresponding":false},{"id":231133,"name":"Michèle Ramsay","orcid":"0000-0002-4156-4801","position":12,"is_corresponding":false},{"id":929,"name":"Diederick E. Grobbee","orcid":"0000-0003-4472-4468","position":13,"is_corresponding":false},{"id":368795,"name":"Engelbert A. Nonterah","orcid":"0000-0001-8491-6478","position":0,"is_corresponding":true}],"reference_count":51,"raw_metadata":null,"created_at":"2026-07-19T00:24:41.993282Z","pmid":"35471573","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}