Hyperlipidemia; Socioeconomic Status; Cardiorenal Syndrome; NHANES


Cardiovascular Diseases | Clinical Epidemiology | Community Health and Preventive Medicine


Purpose. Elevated cholesterol is known to be associated with chronic kidney disease (CKD) and cardiovascular disease (CVD) independently. Cardiorenal syndrome (CRS), a recently defined syndrome, is characterized by renal failure that is closely interrelated to cardiac dysfunction. The effect of socioeconomic status on cardiorenal syndrome has not been explored in a multi-ethnic population. In this retrospective secondary analysis, the hypothesis was tested if socioeconomic status modifies the effect of hyperlipidemia on CRS.

Methods. The National Health and Nutrition Examination Survey (NHANES) is a cross sectional survey done on the non-institutionalized population of the United States. All patients from the NHANES study, 20 years and older between the years 1999-2010 were included in the analysis. CRS was determined using a standard GFR equation and history of CVD. Analysis was performed using complex samples logistic regression to determine the relationship of hyperlipidemia on CRS.

Results. Data on CRS status was available for 24,625 individuals (48.9% males & 51.1% females) and was representative of 173,805,863 individuals. The overall unadjusted odds ratio of CRS for hyperlipidemia to no hyperlipidemia was 3.01 (95% confidence interval [CI], 2.62-3.47, p < 0.001). The adjusted OR was elevated, 2.20 (CI 1.20-4.05, p < 0.01), among individuals living below poverty threshold but close to 1.0 (1.63 CI 1.31-2.03, p < 0.001) among patients above poverty threshold, after the results were controlled for medical risk factors and demographic risk factors.

Conclusions. Hyperlipidemia is strongly associated with CRS in a nationally representative multi-ethnic population and must be taken into special consideration when treating underprivileged patients. Longitudinal studies should further examine this association and demonstrate how socioeconomic status plays a role.