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Excess Protein in Urine Is Indicator of Heart Disease Risk Among Whites

Researchers at Wake Forest University School of Medicine note that proteinuria, a long accepted indicator of heart disease risk, has far less impact on blacks than it does on whites.   Medical experts believe that the more protein in a patient’s urine, the greater the risk for heart disease and stroke. 

The study indicates that excess protein in the urine — a common finding with progressive kidney disease in individuals with diabetes — is strongly associated with calcium deposition in the major arteries in white patients, but not in black patients.  Therefore, they conclude, that proteinuria appears to be associated with an increased risk of heart attack in the white ethnic group. There may be biologic factors predisposing whites to heart disease or protecting blacks from developing it, the scientists note.

According to the American Association for Critical Illness Insurance which tracks data related to cancer, heart disease and stroke, in the general community, blacks have more heart disease risk factors than whites, including higher blood pressures and LDL (known as “bad”) cholesterol levels, and higher blood sugars in patients with diabetes. As such, they face a higher risk for heart attack than whites. 

Several large studies have shown that despite having more risk factors for hardening of the arteries, black men had less calcium in the heart arteries — one-eighth the amount — compared to white men. In addition, given access to equivalent healthcare as whites, blacks with diabetes face only half the risk of a heart attack, indicating that blacks appear to somehow be protected from the cardiovascular effects of these risk factors. 

The researchers evaluated whether excess protein excretion in the urine — a major heart disease risk factor in whites — was also a risk factor for heart and vascular disease in blacks. The level of urine protein was examined in over 800 white participants and nearly 400 black participants, all with diabetes. Participants were also tested for atherosclerosis, based on the buildup of calcium in their major arteries. 

The research team found that in the white population, greater amounts of protein in the urine were directly associated with higher levels of atherosclerosis. This association, however, was not seen in the black study population. 

The study appears in the January issue of Diabetes Care.

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