Subclinical Atherosclerosis Twice as Likely in Young Black Adults Than Their Hispanic Peers

Young non-Hispanic Black adults may be twice as vulnerable to early subclinical atherosclerosis as their Hispanic counterparts, according to a study published July 11 in the Journal of American College of Cardiology.

Josep Iglesies-Grau, MD, et al., examined data from 436 adults from a multiethnic, underserved community in Harlem, New York City, who were participating in the FAMILIA study, with 147 participants self-identified as Black and 289 Hispanic. The average age of this cohort was 38 years and 82% were women; none had a history of cardiovascular disease at study entry. Each participant answered a comprehensive questionnaire, had their blood pressure and cholesterol checked, and had bilateral carotid and femoral 3D vascular ultrasounds.

Results showed the 10-year Framingham Cardiovascular Risk Score was a mean 4.0%, with no difference across the groups, and the prevalence of subclinical atherosclerosis was significantly higher in the non-Hispanic Black participants than in the Hispanic participants (12.9% vs. 6.6%). Notably, after adjustment for the 10-year Framingham score, classic cardiovascular risk, lifestyle and socioeconomic factors, the non-Hispanic Black participants had a higher odds of having subclinical atherosclerosis (3.45; 95% confidence interval, 1.44-8.29; p=0.006), compared with the Hispanic participants.

"These findings may in part help to explain the observed differences in cardiovascular disease prevalence between racial and ethnic groups," says Valentin Fuster, MD, PhD, MACC, a study author. "Until underlying biological factors and other undiscovered cardiovascular risk factors are better understood and can be addressed by precision medicine, affordable noninvasive imaging techniques such as the portable 3D vascular ultrasounds used in this study, which are easily used and affordable, can be an important form of early detection in underserved communities, and provide valuable information about population disparities and increase the precision of health promotion and prevention programs."

In an accompanying editorial comment, Ramdas G. Pai, MBBS, FACC, and Vrinda Vyas, MBBS, acknowledge the knowledge gap for adequately minimizing cardiovascular risk in certain racial and ethnic groups and point out the study is not free of limitations. "The major limitation … is that it was a cross-sectional study; therefore, causal relationships cannot be determined," note Pai and Vyas. "Social determinants of health, diet, and pollution may have epigenetic effects on the phenome and may be heritable as well, making it important for these often-ignored factors to be studied in detail."

Clinical Topics: Cardiovascular Care Team, Dyslipidemia, Prevention, Lipid Metabolism, Nonstatins, Diet

Keywords: Cardiovascular Diseases, Cross-Sectional Studies, Ethnic Groups, Blood Pressure, Prevalence, New York City, Confidence Intervals, Precision Medicine, Social Determinants of Health, Risk Factors, Atherosclerosis, Socioeconomic Factors, Life Style, Cholesterol, Diet, Surveys and Questionnaires, Heart Disease Risk Factors, Biological Factors, Health Promotion, Cardiology, Epigenesis, Genetic, African Americans, Hispanic Americans

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