Discovering the Full Spectrum of Cardiovascular Disease

Smith, Sidney C.; Clark, Luther T.; Cooper, Richard S.; Daniels, Stephen R.; Kumanyika, Shiriki; Ofili, Elizabeth; Quiñones, Miguel Á.; Ruíz-Sánchez, Esaú; Saunders, Elijah; Tiukinhoy, Susan

doi:10.1161/01.cir.0000157743.54710.04

Cited by 111 publications

(70 citation statements)

References 34 publications

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“…Obesity, diabetes, and hypertension are more prevalent in the black and Hispanic populations compared with the Asian population. 27 Although these comorbidities may not contribute directly to ESTS-specific mortality, they may do so indirectly, by making these populations less able to respond to the burden of disease. This explanation is tempered, however, by the unexpectedly low disease-specific mortality rates observed among Hispanics in our study.…”

Section: Discussionmentioning

confidence: 99%

Racial and ethnic differences in treatment and survival among adults with primary extremity soft‐tissue sarcoma

Martinez

Robbins

Meyers³

et al. 2008

Cancer

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BACKGROUND.Limb preservation is preferred to amputation for patients with extremity soft tissue sarcoma (ESTS). Disparities in the treatment and outcomes of several malignancies have been reported, but not for ESTS. The authors assessed racial/ethnic differences in patient‐ and tumor‐specific characteristics, treatment, and disease‐specific survival in a population of adults with ESTS.METHODS.The Surveillance, Epidemiology, and End Results (SEER) database was used to identify 6406 adult patients with ESTS who were diagnosed and treated between 1988 and 2003. Patients were categorized into 1 of 4 racial/ethnic groups: whites, blacks, Hispanics, and Asians. Comparisons of treatment and disease‐specific survival were conducted with regression models that adjusted for patient age, sex, SEER geographic region, extent of disease, tumor grade, tumor size, and histology.RESULTS.Relative to whites, blacks received lower rates of adjuvant radiation with surgery (odds ratio [OR], 0.77; 95% confidence interval [95% CI], 0.66–0.90). Hispanics received significantly lower rates of limb‐sparing surgery (OR, 0.76; 95% CI, 0.59–0.97). In a multivariate analysis controlling for patient age, sex, SEER geographic region, extent of disease, tumor grade, tumor size, and histology, blacks displayed a worse disease‐specific survival (hazard ratio [HR] 1.39; 95% CI, 1.13–1.70), whereas Asians demonstrated superior disease‐specific survival (HR, 0.67; 95% CI, 0.46–0.97).CONCLUSIONS.There were significant racial/ethnic differences in treatment and survival among adults with ESTS. Compared with whites, survival was poorer for blacks but better for Asians. These disparities were not explained by differences in patient or tumor characteristics. Cancer 2008. © 2008 American Cancer Society.

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Section: Discussionmentioning

confidence: 99%

Racial and ethnic differences in treatment and survival among adults with primary extremity soft‐tissue sarcoma

Martinez

Robbins

Meyers³

et al. 2008

Cancer

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“…Caucasians present most often with lipid abnormalities, including hypertriglyceridemia and low HDL cholesterol 3 ; African Americans and Asians present with hypertension; whereas diabetes is diagnosed more frequently among Hispanics, Pacific Islanders, and Native Americans. 4 Abdominal obesity has increased drastically in all men over the past 40 years in the United States, regardless of race or ethnicity, and nearly 33% of adult men now have a waist circumference >102 cm (or approximately 40 inches). 5 A number of recent reports have suggested that prostate cancer may be associated with features of the metabolic syndrome.…”

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confidence: 99%

Features of the metabolic syndrome and prostate cancer in African‐American men

Beebe‐Dimmer

Dunn

Sarma

et al. 2007

Cancer

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BACKGROUND.Metabolic syndrome refers to a cluster of conditions that includes hypertension, dyslipidemia, central adiposity, and high blood glucose levels. Over the past decade, a growing body of literature suggests that metabolic syndrome may be associated with several different forms of cancer. Because prostate cancer risk is highest among African Americans, and these men, similarly, are more prone to developing specific features of the metabolic syndrome, including hypertension and type‐2 diabetes, any relationships would have a significant impact on developing strategies for the primary prevention of prostate cancer.METHODS.The Flint Men's Health Study is a community‐based, case‐control study of prostate cancer conducted exclusively among African Americans. Prostate cancer cases and controls completed an interviewer‐administered questionnaire that asked about the respondent's history of high blood pressure and diabetes. All men also participated in a physical examination in which several measures of body composition, including waist circumference, were collected.RESULTS.Hypertension was reported more commonly among men with prostate cancer (cases) compared with men in the control group (odds ratio [OR]. 2.4; 95% confidence interval [95% CI], 1.5–3.7), and cases were more likely to have a waist circumference >102 cm (OR, 1.8; 95% CI, 1.2–2.9). However, self‐reported diabetes was not associated with prostate cancer risk. The men with prostate cancer also were more likely than controls to exhibit multiple syndrome characteristics (OR, 1.9; 95% CI, 1.2–3.0).CONCLUSIONS.The current results indicated that features of the metabolic syndrome, specifically abdominal obesity and hypertension, are associated with prostate cancer in African‐American men. This relationship, if it is proved causal, suggests that prevention or control of these conditions eventually may lead to a reduction in the incidence of prostate cancer in this high‐risk minority group. Cancer 2007 © 2007 American Cancer Society.

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“…The diagnosis of MetS is usually based on the clustering of these metabolic abnormalities more often than would be predicted by chance, 15 but considerable debate exists about the independence of the RR of CVD and death associated with the diagnosis of MetS. [16][17][18][19] The findings from our study are consistent with the existing body of literature on the age, gender and racial/ethnic differences in the prevalence of the defining components of MetS. 20,21 Although the clustering of the metabolic abnormalities in MetS has been traditionally attributed in part to insulin resistance, 22 other studies suggest that the prevalence of several of its components can be significantly affected by many psychosocial rather than physiologic factors.…”

Section: Discussionmentioning

confidence: 99%

The Relative Risk of Cardiovascular Death among Racial and Ethnic Minorities with Metabolic Syndrome: Data from the NHANES-II Mortality Follow-Up

Martins¹,

Tareen²,

Ogedegbe³

et al. 2008

Journal of the National Medical Association

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The tendency for selected cardiovascular disease (CVD) risk factors to occur in clusters has led to the description of metabolic syndrome (MetS). The relative impact of the individual risk factor on the overall relative risk (RR) for cardiovascular death from metabolic syndrome is not well established and may differ across the different racial/ethnic groups.Using data from the National Health and Nutrition Examination Survey (NHANES II) mortality follow-up (NH2MS), we determined the prevalence and RR of cardiovascular death for individual components in the overall population and across racial and ethnic groups.The prevalence of MetS components varied significantly across gender and racial/ethnic groupings. The RR for CVD also varies for the number and different components of MetS. The adjusted RR for cardiovascular death was highest with diabetes (3.23; 95% CI: 2.70-3.88), elevated blood pressure (2.28; 95% CI: 1.94-2.67) and high triglycerides (1.63; 95% CI: 1.34-2.00). Although the RR for cardiovascular death differs significantly for some of the different components, the overall findings were similar across racial/ethnic groups. The two components that confer the highest risks for death are more prevalent in African Americans.We concluded that the RR of cardiovascular death associated with the diagnosis of MetS varies depending on the number and components used to establish the diagnosis of MetS and the racial/ ethnic characteristic of the participants.

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Discovering the Full Spectrum of Cardiovascular Disease

Cited by 111 publications

References 34 publications

Racial and ethnic differences in treatment and survival among adults with primary extremity soft‐tissue sarcoma

Racial and ethnic differences in treatment and survival among adults with primary extremity soft‐tissue sarcoma

Features of the metabolic syndrome and prostate cancer in African‐American men

The Relative Risk of Cardiovascular Death among Racial and Ethnic Minorities with Metabolic Syndrome: Data from the NHANES-II Mortality Follow-Up

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