Background
APOL1
high‐risk genotypes are associated with increased risk for hypertension‐attributed kidney disease among Black adults in the United States. Biopsy studies show differences in kidney vasculature by
APOL1
status; less is known about the variants' associations with systemic vascular and endothelial function. Whether
APOL1
risk variants are associated with blood pressure (BP) is also uncertain.
Methods and Results
Using linear regression, we examined cross‐sectional associations of
APOL1
risk genotypes (high=2 risk alleles, low=0 or 1 risk allele) with subclinical measures of vascular function (small arterial elasticity, n=1586; large arterial elasticity, n=1586; ascending aortic distensibility, n=985) and endothelial function (flow‐mediated dilation, n=777). Using linear mixed‐effects models, we studied longitudinal associations of
APOL1
risk genotypes with BP (n=1619), adjusting for age, sex, and African ancestry. Among 1619 (12%
APOL1
high‐risk) Black participants in MESA (Multi‐Ethnic Study of Atherosclerosis), mean age was 62 years old, 58% had hypertension, and mean systolic BP was 131 mm Hg at baseline. At examination 1 (2000–2002), there was no significant difference in small arterial elasticity, large arterial elasticity, ascending aortic distensibility, or flow‐mediated dilation in participants with
APOL1
high‐ versus low‐risk genotypes (
P
>0.05 for all). Over a mean follow‐up of 7.8 years, relative annual changes in systolic and diastolic BP and pulse pressure did not differ significantly by
APOL1
risk status (between‐group differences of −0.20, −0.14, and −0.25, respectively;
P
>0.05 for all).
Conclusions
Among Black participants in MESA,
APOL1
high‐risk genotypes were not associated with subclinical vascular and endothelial function or BP trajectories. The relationship of
APOL1
with kidney disease may be intrinsic to the kidney rather than through peripheral effects on systemic vasculature or BP.
Nebivolol in High-Risk, Obese African Americans With Stage 1 Hypertension: Effects on Blood Pressure, Vascular Compliance, and Endothelial Function
