Incidence and prevalence of modifiable cardiovascular risk factors according to kidney function, gender and geography

Aim:

To report the incidence and prevalence of modifiable cardiovascular disease risk factors (diabetes and hyperlipidaemia) according to kidney function, gender, and geography.

Background:

Cardiovascular (CV) disease increases as kidney function decreases. Identifying individuals or communities with a high prevalence of modifiable vascular risk factors for cardiovascular events may allow targeted interventions to improve longer-term health.

Methods:

The CKD.TASlink study takes a state-wide approach using data linkage of five health (public hospital admissions, emergency presentations, ANZDATA, cancer and death registry) and two pathology (community and hospital) datasets. The study population consists of any adult who had a creatinine test between 1/1/2004 and 31/12/2017. We defined chronic kidney disease (CKD) as two measures of eGFR<60 mL/min/1.73 m2 , at least 3-months apart. We examined the distribution of HbA1c >6.5%, LDL >3 mmol/L and Vitamin D < 70 nmol/L in this population and data reported using age-standardized rate and rate ratio (RR) without 95% confidence intervals (given whole of population approach).

Results:

Of the study population (n = 460,737, 86.8% of the state’s total population), 398,661 (86.5%) had lipids, HbA1C or vitamin D measured. We identified 56,438 Tasmanians with CKD during the study period (agestandardized annual incidence 1%; prevalence 6.5%). In 2017, the age-standardized prevalence per 10,000 population of HbA1C >6.5% was 373, LDL >3 mmol/L was 1141 and Vitamin D < 70 nmol/L was 799. The prevalence of HbA1C >6.5% varied by gender (men to women rate ratio (RR) 1.29), geography by statistical area 3 (highest to lowest, RR 1.89) and by year (2017 to 2007, RR 1.36).

Conclusions:

State-wide data linkage analysis revealed significant gender, geographic and temporal variations in modifiable cardiovascular risk factors, including among people with CKD.