Black Americans with hypertension open to genetic testing, concerned about kidney disease
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Most Black American patients at hypertension and nephrology clinics from a single center reported that apolipoprotein L1 genetic testing would motivate them to change health-related behaviors, according to a published research letter.
Further, 94% reported concern about kidney disease and the study population was receptive to receiving apolipoprotein L1 (APOL1) testing and counseling.
“To date, few studies have examined patient perspectives and attitudes about testing for APOL1,” Krista L. Lentine, MD, PhD, a professor at Saint Louis University Center for Abdominal Transplantation, and colleagues wrote. “Since APOL1 risk variants have only been detected among individuals of recent African ancestry, it is essential to engage and incorporate patient perspectives and attitudes about APOL1 genotyping in clinical decision-making and formulation of best practices given impacts of racism on Black Americans as well as mistrust and underrepresentation of Black Americans in clinical trials.”
In a pilot study, researchers evaluated the attitudes and concerns related to APOL1 genetic testing and kidney risk management among 128 self-identified Black Americans (55% were women; mean age was 57 years; 73% had obesity). Patients completed baseline surveys about their attitudes and concerns before researchers collected blood samples to be sent to the lab for APOL1 genotyping.
When asked, 94% of patients reported concern about kidney disease and 94% also thought being tested for genes that may impact kidney disease was a good idea. Further, 81% stated they would want APOL1 testing for their children.
Two patients reported they would take no action if they were found to have high-risk APOL1 genotypes. Testing revealed 50 patients had no APOL1 RRVs (high-risk genotypes), 56 patients had one APOL1 RRVs, while 22 patients had two APOL1 RRVs.
Overall, patients reported knowledge of a high-risk APOL1 genotype would lead them to make positive changes in health-related behaviors.
“Although we did not assess health care providers’ attitudes about APOL1 testing, identifying APOL1 risk status in patients with [chronic kidney disease] CKD may guide clinicians in monitoring and managing patients at risk of rapid progression,” Lentine and colleagues wrote. They added, “In conclusion, we report that Black American patients at an urban Midwestern medical center were receptive toward APOL1 genetic testing and believed that testing would motivate changes in health-related behaviors.”
Researchers noted these findings may not apply to other populations, given that these patients may have been more interested in their health because they agreed to participate in the study, and the ratio of high-risk genotypes was higher than in the general population.
“Further research is necessary to determine the optimal patient-centered use of this emerging risk-assessment tool,” Lentine and colleagues concluded.
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