Lipid level differences and hypertension effect in blacks and whites with type II diabetes

We sought to determine whether lipid levels in black patients with type II diabetes with and without hypertension differ from those in white patients. Lipid levels were screened in 207 blacks and 103 whites with type II diabetes visiting a weekly diabetes clinic in a southeastern US regional community hospital. Levels of high- and low-density lipoprotein cholesterol were significantly higher in blacks than in whites: 1.30 +/- 0.34 vs 1.05 +/- 0.27 mmol/L (P < .001) and 3.73 +/- 1.23 vs 3.31 +/- 1.11 mmol/L (P = .01), respectively; triglycerides were higher in whites: 3.90 +/- 4.58 vs 1.96 +/- 1.51 mmol/L (P < .001). White hypertensive women had higher cholesterol and triglyceride levels and lower high-density lipoprotein cholesterol levels than white normotensive women (adjusted for age); no differences existed between black hypertensive and normotensive women when we adjusted for age. Seventy-two percent of blacks and 85% of whites had an abnormal lipid value (P = .01). Phenotype distribution was significantly different: 58.7% of blacks with abnormal lipids were in phenotype IIA (elevated low-density lipoprotein cholesterol with normal triglycerides), and 16.7% in IVA and B combined (elevated triglycerides) (P < .001), whereas whites were 17.0% and 52.3%, respectively. Blacks demonstrated a different dyslipidemia compared to whites. The contrasting effect of hypertension on triglyceride and cholesterol levels in white women with diabetes compared to black women suggests a racial difference in the relationship between hypertension and lipids among patients with diabetes.