Two variations in the apo L1 gene (APOL1) common in West African and African American populations are strongly associated with development of ESKD. Studies evaluating whether these APOL1 kidney-risk variants increase the risk of cardiovascular disease have had inconsistent results. The authors conducted a two-stage meta-analysis of individual participant data from eight large cohorts with data on APOL1 kidney-risk variants. The analysis included 21,305 blacks and assessed the relationship between APOL1 kidney-risk variants and several types of cardiovascular disease and death. In a recessive genetic model adjusted for demographics, comorbidities, and kidney measures, there were no significant associations between APOL1 kidney-risk genotypes and death or the composite outcome of incident cardiovascular disease, which included coronary heart disease, stroke, myocardial infarction, and heart failure. There were also no significant associations between these variants and coronary heart disease, stroke, myocardial infarction, and heart failure when the conditions were considered individually. This study suggests that the APOL1 kidney-risk variants may not have a direct effect on cardiovascular disease separate from the effects of kidney disease itself.