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Cardiovascular risk reduction among African Americans: a call to action
1David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA. kwatson@mednet.ucla.edu
Insights
African Americans face higher risks for cardiovascular disease and type-2 diabetes. Effective pharmacologic therapies, including antihypertensives and statins, are crucial for managing hypertension and dyslipidemia in this population.
Area of Science:
- Cardiology
- Public Health
- Pharmacology
Background:
- African Americans experience higher rates of cardiovascular morbidity and mortality compared to other racial groups.
- This population also bears a disproportionate burden of type-2 diabetes mellitus.
- Healthcare access and treatment intensity may contribute to these disparities, alongside modifiable risk factors.
Purpose of the Study:
- To highlight the significant cardiovascular disease (CVD) risk in African Americans.
- To emphasize the opportunity for prevention and treatment through managing hypertension and dyslipidemia.
- To discuss the role of pharmacologic therapies in achieving treatment goals.
Main Methods:
- Review of clinical trial data on antihypertensive and lipid-lowering therapies in African Americans.
- Analysis of risk factors including hypertension and dyslipidemia prevalence.
- Assessment of treatment efficacy in achieving target blood pressure and low-density-lipoprotein cholesterol levels.
Main Results:
- Antihypertensive regimens, especially those with diuretics, are effective in African Americans.
- Potent statins effectively lower low-density-lipoprotein cholesterol to goal levels in this demographic.
- Aggressive treatment goals for blood pressure and cholesterol are achievable.
Conclusions:
- Managing hypertension and dyslipidemia with effective pharmacologic therapies is vital for reducing cardiovascular risk in African Americans.
- Lifestyle interventions combined with appropriate medications can significantly improve cardiovascular outcomes.
- Further research and targeted interventions are warranted to address health disparities.
Abstract:
African Americans are at greater risk for cardiovascular morbidity and mortality than European Americans or Asians. They also bear a disproportionately greater burden from type-2 diabetes mellitus. Not as much access to healthcare and less intensive use of available therapies may explain some of these disparities. However, the high prevalence of potentially modifiable risk factors, particularly hypertension and dyslipidemia, in African Americans also provides great opportunity for the prevention and treatment of cardiovascular disease in this population. In addition to lifestyle approaches, achieving aggressive goals for blood pressure (< or =130/80 mmHg) and low-density-lipoprotein cholesterol (<100 mg/dL, or <70 mg/dL for patients at very high cardiovascular risk, including those with diabetes) will necessitate the use of effective pharmacologic therapies. Clinical trial data indicate that antihypertensive regimens, particularly those that include a diuretic, are as effective in African Americans as in other racial/ethnic groups. Moreover, potent statins have been shown to decrease low-density-lipoprotein cholesterol to goal levels in African-American patients.
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