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Racial differences in endothelial function in postmenopausal women.

Laura R Loehr1, Mark A Espeland, Kim Sutton-Tyrrell

  • 1Department of Internal Medicine, Sections on Section on Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA.

American Heart Journal
|October 2, 2004
PubMed
Summary

African American women have significantly lower brachial artery flow-mediated dilation (FMD) compared to Caucasian women, indicating impaired endothelial function. This racial difference in FMD may contribute to the higher cardiovascular disease (CVD) risk observed in African American women.

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Area of Science:

  • Cardiovascular Health
  • Vascular Biology
  • Racial Disparities in Health

Background:

  • Racial disparities in cardiovascular mortality among women are not fully understood.
  • Preliminary evidence suggests differences in endothelial function may explain cardiovascular disease (CVD) risk variations between African American and Caucasian women.

Purpose of the Study:

  • To investigate racial differences in endothelial function between African American and Caucasian women.
  • To analyze brachial artery flow-mediated dilation (FMD) measures in women from the Cardiovascular Health Study (CHS).

Main Methods:

  • Brachial artery FMD was measured using ultrasound in 1330 Caucasian and 297 African American women (mean age 78.4 years).
  • Statistical analyses (general linear models) adjusted for numerous demographic, clinical, and medication variables.

Related Experiment Videos

  • Comparisons were made between racial groups, including stratifications by CVD history and disease presence.

    • Main Results:

    • African American women exhibited significantly reduced absolute and percent changes in brachial artery diameter during FMD compared to Caucasian women (P <.0001 and P =.0002, respectively).
    • These differences persisted even when stratified by history of CVD (P =.02 and P =.001) or presence of vascular disease (P =.01 and P =.03).

    Conclusions:

    • Brachial artery FMD is lower in African American women than in Caucasian women, a difference that remains significant after multivariable adjustment.
    • Impaired endothelial function may underlie the elevated CVD risk in African American women.
    • Further research is needed to determine if African American women would uniquely benefit from interventions targeting endothelial health.