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Physiology, genetics, and cardiovascular disease: focus on African Americans
1Cardiovascular Research Institute, Morehouse School of Medicine, 720 Westview Drive SW, Atlanta, GA 30310, USA. ggibbons@msm.edu
Insights
African Americans face higher cardiovascular disease mortality due to genetic variants affecting key regulatory systems. Understanding these differences can lead to personalized treatments for better health outcomes.
Area of Science:
- Cardiovascular disease research
- Genetics and personalized medicine
- Health disparities
Background:
- Cardiovascular disease (CVD) disproportionately affects African Americans, with higher mortality rates compared to white Americans.
- Obesity and diabetes, key CVD risk factors, are more prevalent in the African-American community.
- The cardiovascular system is regulated by opposing mediators: angiotensin II (pro-inflammatory, pro-atherogenic) and peroxisome proliferator activated-receptor gamma (anti-inflammatory, anti-atherogenic).
Purpose of the Study:
- To explore the role of genotypic variants in cardiovascular disease susceptibility and treatment response in African Americans.
- To investigate how genetic differences in regulatory systems like angiotensin II and peroxisome proliferator activated-receptor gamma contribute to health disparities.
- To identify potential targets for tailored therapies based on individual genetic profiles.
Main Methods:
- Review of existing literature on cardiovascular disease, risk factors, and genetic variations in different ethnic populations.
- Analysis of the known functions of angiotensin II and peroxisome proliferator activated-receptor gamma in cardiovascular regulation.
- Examination of genotypic variants within the adrenergic system and their differential frequencies across ethnic groups.
Main Results:
- Specific genotypic variants influencing angiotensin II and peroxisome proliferator activated-receptor gamma pathways show varying frequencies between African Americans and European Americans.
- These genetic differences may explain disparities in cardiovascular disease susceptibility and treatment efficacy.
- Adrenergic system genotypic variants are also noted to differ in frequency, potentially impacting cardiovascular health.
Conclusions:
- Genotypic variations play a significant role in the disproportionate burden of cardiovascular disease among African Americans.
- Understanding these genetic differences is crucial for addressing health disparities.
- Personalized therapeutic strategies, informed by individual genetic profiles, hold promise for improving cardiovascular health outcomes in diverse populations.
Abstract:
The disproportionate impact of cardiovascular disease in African Americans is well recognized. Not only do risk factors such as obesity occur at a higher rate in the African-American community, but this population experiences a greater mortality from cardiovascular disease than their white counterparts. The cardiovascular system is regulated in part by two opposing mediators linking the risk factors of obesity, vascular dysfunction, and diabetes. One of these mediators--angiotensin II--increases blood pressure, impairs endothelial function, decreases peroxisome proliferator activated-receptor gamma, and is proinflammatory, growth stimulating, profibrotic, and proatherogenic. The other mediator, peroxisome proliferator activated-receptor gamma, lowers blood pressure, improves endothelial function, decreases angiotensin II type 1 receptor function, and is anti-inflammatory, growth-inhibiting, antifibrotic, and antiatherogenic. Genotypic variants have been discovered that affect the functioning of both of these important systems. Some of these variants--like some genotypic variants discovered in the adrenergic system--occur with different frequencies in African Americans than in Americans of European descent and may help to explain racial/ethnic differences in susceptibility to cardiovascular disease and aspects of the response to treatment. Recognition of these genotypic differences may permit the development of therapies tailored to individual patients.
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