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Traditional coronary risk factors in African Americans
1Department of Medicine, Meharry Medical College, Nashville, Tennessee 37208, USA.
Insights
African Americans experience higher coronary heart disease mortality due to prevalent risk factors like hypertension and diabetes. Addressing these factors, including cholesterol and blood pressure, is crucial for reducing cardiovascular disease burden.
Area of Science:
- Cardiovascular Medicine
- Public Health
- Epidemiology
Background:
- Traditional coronary artery disease (CAD) risk factors are well-established contributors to coronary heart disease (CHD).
- African Americans exhibit a higher prevalence of key risk factors, including hypertension, diabetes mellitus, obesity, and cigarette smoking.
- This increased risk factor burden may explain the disproportionately high CHD mortality rates observed in this population.
Purpose of the Study:
- To review the impact of traditional cardiovascular risk factors on coronary heart disease development and mortality.
- To highlight the role of specific risk factors prevalent in African Americans.
- To emphasize the need for innovative strategies to mitigate CHD in at-risk populations.
Main Methods:
- Review of compelling data from randomized lipid-lowering trials.
- Analysis of recent studies on blood pressure reduction and cardiovascular outcomes.
- Examination of the independent and collective roles of diabetes mellitus, cigarette use, physical inactivity, stress, and obesity.
Main Results:
- Lowering low-density lipoprotein cholesterol levels significantly reduces CHD morbidity and mortality.
- Blood pressure reduction demonstrates beneficial effects on cardiovascular mortality.
- Left ventricular hypertrophy, often a consequence of hypertension, appears to independently elevate CHD risk.
- Diabetes mellitus, cigarette use, physical inactivity, stress, and obesity collectively and individually increase CHD morbidity and mortality.
Conclusions:
- The clustering of traditional cardiovascular risk factors in African Americans is a critical factor in their excess CHD mortality.
- Effective management of hypertension, diabetes, obesity, and smoking is essential.
- Innovative approaches are necessary to alter the course of coronary heart disease, particularly in high-risk populations.
Abstract:
The importance of traditional coronary artery disease risk factors in the development of coronary heart disease is well known. African Americans have a higher prevalence of such risk factors as hypertension, diabetes mellitus, obesity, cigarette smoking, and left ventricular hypertrophy, which might account for the disproportionate rate of coronary heart disease mortality in African Americans. Compelling data from randomized lipid-lowering trials show conclusively that lowering cholesterol levels, specifically low-density lipoprotein cholesterol, lowers coronary heart disease morbidity and mortality. Recent data has also demonstrated the beneficial effects of lowering blood pressure on cardiovascular mortality. Left ventricular hypertrophy, which results from elevated blood pressure, seems to raise coronary heart disease risks independently. Diabetes mellitus, cigarette use, physical inactivity, stress, and obesity play critical roles collectively and individually in increasing coronary heart disease, morbidity, and mortality. Clustering of coronary heart disease risk factors in African Americans must be strongly considered to play a critical role in the excess mortality from coronary heart disease seen in African Americans. New innovative approaches are required if the course of coronary heart disease is to be altered.
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