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Ethnic differences in low-density lipoprotein particle size in hypertensive adults
Iftikhar J Kullo1, M Fuad Jan, Kent R Bailey
1Divisions of Cardiovascular Diseases, Mayo Clinic and Foundation, Rochester, MN.
Insights
Hypertensive African Americans have smaller low-density lipoprotein (LDL) particle size than whites, despite favorable HDL cholesterol and triglyceride levels. This finding highlights a potential contributor to their higher coronary heart disease risk.
Area of Science:
- Cardiology
- Genetics
- Public Health
Background:
- Hypertensive African Americans exhibit higher coronary heart disease (CHD) rates compared to non-Hispanic whites.
- This disparity exists despite African Americans typically having higher HDL cholesterol (HDL-C) and lower triglyceride levels.
Purpose of the Study:
- To investigate if low-density lipoprotein (LDL) particle size, a known correlate of lipid traits and CHD risk factor, differs between hypertensive African Americans and whites.
- To determine the association between ethnicity and LDL particle size in hypertensive individuals.
Main Methods:
- Study included 1177 hypertensive African Americans and 860 hypertensive whites.
- LDL particle size measured using polyacrylamide gradient gel electrophoresis.
- Analyses adjusted for CHD risk factors, statin/estrogen use, and lifestyle variables.
Main Results:
- African American men and women had significantly lower LDL particle size than their white counterparts (P < 0.0001).
- This difference persisted after adjusting for multiple CHD risk factors and lifestyle variables.
- Ethnicity was independently associated with smaller LDL particle size in both sexes.
Conclusions:
- Hypertensive African Americans possess smaller LDL particle size compared to hypertensive whites.
- Lower LDL particle size in African Americans may contribute to their elevated CHD risk, independent of HDL-C and triglyceride levels.
Background:
Hypertensive African Americans have higher rates of coronary heart disease (CHD) than their non-Hispanic white counterparts despite having higher HDL cholesterol (HDL-C) levels and lower triglyceride levels.
Objective:
The goal of the present study was to assess whether low-density lipoprotein (LDL) particle size, a correlate of the above lipid traits and a risk factor for CHD, differs between hypertensive African Americans and whites.
Methods:
Participants included 1177 hypertensive African Americans from Jackson MS (60+/-7 years, 72.4% women) and 860 hypertensive whites from Rochester MN (58+/-7 years, 56.7% women). LDL particle size was measured by polyacrylamide gradient gel electrophoresis. Within each sex, we assessed whether ethnicity was significantly associated with differences in LDL particle size after adjustment for CHD risk factors (age, total cholesterol, HDL-C, triglycerides, systolic BP, diabetes, history of smoking, body mass index), statin use, and estrogen use (in women), and "lifestyle" variables (physical activity and alcohol intake).
Results:
Although HDL-C levels were higher and triglyceride levels lower in African Americans, LDL particle size (adjusted for CHD risk factors) was lower (P < 0.0001) in African American men and women than in their white counterparts (mean +/- SD; men, 267.6+/-5.2 A vs. 270.2+/-4.8 A; women 268.7+/-5.1 A vs. 271.3+/-5.1 A). In both sexes, African American ethnicity was associated with lower LDL particle size after adjustment for CHD risk factors, statin use and estrogen use (in women), as well as physical activity and alcohol intake.
Conclusion:
Hypertensive African American men and women have lower LDL particle size than their white counterparts despite having higher HDL-C and lower triglycerides.
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