| Summary: | The relationship of APOL1 renal risk variants to cardiovascular disease (CVD) is controversial and was the subject of this investigation.
Methods: Age, cause of death, and nephrosclerosis (the latter defined by glomerulosclerosis) were analyzed in the autopsies of 162 African Americans and 136 whites genotyped for APOL1 risk alleles.
Results: Sudden deaths represented >75% of CVD autopsies for both races and all-risk genotypes. The average ages of CVD deaths for African Americans with 1 and 2 APOL1 risk alleles were, respectively, 7.0 years (P = 0.02) and 12.2 years (P < 0.01) younger than African Americans with 0 risk alleles and 8.7 years (P = 0.01) and 13.9 years (P = 0.01) younger than whites. Age differences were not significant between African Americans and whites with 0 risk alleles (P = 0.61). The younger CVD deaths of African Americans were associated with less severe glomerulosclerosis with 2 (P = 0.01), although not 1 (P = 0.09), compared with 0 APOL1 risk alleles. Cardiomyopathy was found in 23% of African Americans with 1 and 2 risk alleles and significantly contributed to the lower age (P = 0.01). For non-CVD deaths, age differences were not seen by race (P = 0.28) or among African Americans by risk allele status (P = 0.38).
Conclusion: Carriage of 1 or 2 APOL1 risk alleles in African Americans was associated with earlier age deaths due to coronary artery disease and cardiomyopathy. For 2 risk alleles, the early age was independent of nephrosclerosis.
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