Albuminuria and Premature Atherosclerotic Cardiovascular Disease in U.S. Adults: A Cross-Sectional Analysis of the National Health and Nutrition Examination Survey, 2011-2018.

BACKGROUND

Albuminuria is recognized as a marker of vascular and renal dysfunction and has been linked to adverse cardiovascular outcomes. Its relationship with premature atherosclerotic cardiovascular disease (ASCVD) in the general population remains less clearly defined.

OBJECTIVE

This study examined the association between albuminuria and premature ASCVD among U.S. adults using nationally representative data from the National Health and Nutrition Examination Survey (NHANES) 2011-2018.

METHODS

A cross-sectional analysis was conducted using data from the NHANES 2011 to 2018. The study included adults aged 18 years and older with complete data on exposure, outcome, and covariates. Albuminuria was defined using the urinary albumin-to-creatinine ratio (ACR). Premature ASCVD was defined based on self-reported myocardial infarction, stroke, or coronary heart disease occurring at younger ages. A survey-weighted logistic regression model was used to assess the association while accounting for the complex sampling design.

RESULTS

Albuminuria was associated with higher odds of premature ASCVD after adjustment for demographic and clinical factors. Participants with albuminuria also had a higher burden of hypertension, diabetes, smoking, and chronic kidney disease (CKD). Increasing age and lower income were associated with higher odds of premature disease, while smoking showed a strong association.

CONCLUSION

Albuminuria is associated with premature ASCVD and may serve as a useful marker for early cardiovascular risk identification. These findings support its role in clinical risk assessment and highlight the need for further longitudinal research.