Distinct component profiles and high risk among African Americans with metabolic syndrome: the Jackson Heart Study
Herman Taylor1, Jiankang Liu, Gregory Wilson
1Jackson Heart Study, Jackson State University, University of Mississippi Medical Center, Jackson, Mississippi 39216-4505, USA. htaylor@medicine.umsmed.edu
Insights
Metabolic syndrome is highly prevalent in African Americans, significantly increasing risks for cardiovascular disease (CVD), coronary heart disease (CHD), and cerebrovascular disease (CBD). Low HDL cholesterol and abdominal obesity are key contributors.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Cardiovascular disease (CVD) and diabetes pose significant health threats to African Americans.
- The role of metabolic syndrome in this population remains under-investigated.
Purpose of the Study:
- To determine the prevalence of metabolic syndrome in the Jackson Heart Study (JHS) cohort.
- To assess the relationship between metabolic syndrome and CVD in African Americans.
Main Methods:
- Analysis of 5,302 participants (aged >=21) from the JHS cohort (2000-2004).
- Logistic regression used to estimate odds ratios (ORs) for coronary heart disease (CHD) and cerebrovascular disease (CBD) in relation to metabolic syndrome.
- Diabetic participants were excluded from the analysis.
Main Results:
- Metabolic syndrome prevalence was 43.3% in women and 32.7% in men (aged 35-84).
- Highly prevalent components included elevated blood pressure (70.4%), abdominal obesity (64.6%), and low HDL cholesterol (37.2%).
- Metabolic syndrome was associated with significantly increased ORs for CVD (1.7), CHD (1.7), and CBD (1.7).
Conclusions:
- Metabolic syndrome prevalence in the JHS cohort is among the highest globally.
- Metabolic syndrome is significantly associated with increased risks of CVD, CHD, and CBD in African Americans.
- Abdominal obesity, elevated blood pressure, and low HDL cholesterol are prominent contributors, with low HDL being a leading factor.
Objective:
Health of African Americans is seriously threatened by unremitting epidemics of diabetes and cardiovascular disease (CVD). However, the role of metabolic syndrome in the African-American population has not been investigated widely. This study examined the prevalence of metabolic syndrome and assessed its cross-sectional relationship to CVD in the Jackson Heart Study (JHS) cohort.
Research Design And Methods:
A total of 5,302 participants aged >or=21 years who were recruited at baseline during 2000-2004 were analyzed for this study. Adjusted odds ratios (ORs) were estimated in a logistic regression analysis for coronary heart disease (CHD) and cerebrovascular disease (CBD) in those with and without coexisting metabolic syndrome. Diabetic participants were excluded.
Results:
Among those aged 35-84 years, metabolic syndrome prevalence was 43.3% in women and 32.7% in men. Elevated blood pressure (70.4%), abdominal obesity (64.6%), and low HDL cholesterol (37.2%) were highly prevalent among those with metabolic syndrome. Prevalence rates for CVD, CHD, and CBD were 12.8, 8.7, and 5.8%, respectively. After adjustment for age and sex, metabolic syndrome was associated with increased age- and sex-adjusted ORs for CVD (OR 1.7 [95% CI 1.4-2.1]), CHD (1.7 [1.4-2.2]), and CBD (1.7 [1.3-2.3]) compared with those without CVD, CHD, or CBD.
Conclusion:
Metabolic syndrome prevalence in the JHS is among the highest reported for population-based cohorts worldwide and is significantly associated with increased ORs for CVD, CHD, and CBD. Abdominal obesity, increased blood pressure, and low HDL cholesterol (without triglyceride elevation) are surprisingly prominent. A high prevalence of low HDL emerges as a leading contributor to metabolic syndrome among African Americans in this large African-American cohort.
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