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Published on: September 26, 2018

High-risk African Americans with multiple risk factors for cardiovascular disease: challenges in prevention,

Richard Allen Williams1, James R Gavin, Robert A Phillips

  • 1Department of Medicine, The David Geffen School of Medicine at UCLA, Minority Health Institute, Los Angeles, California, USA.

Ethnicity & Disease
|August 30, 2006
PubMed

Insights

Coronary heart disease (CHD) mortality disproportionately affects African Americans. This study proposes strategies for early detection and management of the African American multiple-risk patient (AAMRP) to address this disparity.

Area of Science:

  • Cardiovascular Health
  • Health Disparities
  • Metabolic Syndrome Research

Background:

  • Coronary heart disease (CHD) is a leading cause of death in the US, with higher mortality rates in African Americans compared to Whites.
  • Trends of increased physical inactivity, smoking, and obesity are observed in both African American and White populations.
  • Metabolic syndrome, characterized by obesity, hypertension, dyslipidemia, and insulin resistance, affects millions, with African Americans exhibiting unique risk profiles.

Purpose of the Study:

  • To address the disproportionate burden of CHD in African Americans.
  • To introduce the concept of the "African American multiple-risk patient (AAMRP)" to describe patients with a constellation of risk factors.
  • To propose clinical and public health strategies for early detection and aggressive management of AAMRP.

Main Methods:

  • Review of existing epidemiological data on CHD, metabolic syndrome, and risk factors in African Americans and Whites.
  • Analysis of differential risk factor prevalence and impact in African Americans.
  • Development of a conceptual framework for the AAMRP.

Main Results:

  • CHD mortality remains elevated in African Americans despite previous declines.
  • African Americans exhibit greater insulin resistance, higher blood pressure, and increased obesity compared to Whites, even with similar metabolic syndrome prevalence.
  • Combined risk factors in African Americans confer greater than additive risks, leading to later diagnoses and poorer outcomes.

Conclusions:

  • The AAMRP presents significant clinical and public health challenges.
  • Early detection and aggressive management strategies are crucial for mitigating CHD risk in this population.
  • Targeted interventions are needed to address the unique risk profiles and disparities faced by African Americans regarding cardiovascular health.

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