Race-Ethnicity and Determinants of Carotid Atherosclerosis in a Multiethnic Population

Sacco, Ralph L.; Roberts, J. Kirk; Boden‐Albala, Bernadette; Gu, Qing; Lin, I‐Feng; Kargman, D. E.; Berglund, Lars; Hauser, W. Allen; Shea, Steven; Paik, Myunghee Cho

doi:10.1161/01.str.28.5.929

Cited by 146 publications

(121 citation statements)

References 38 publications

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“…13 Regarding SBI prevalence, the ARIC study found that non-white race (predominantly black) was associated with 64% increased odds of having SBI compared to whites. 9 Although the prevalence of SBI in our study did not differ by race-ethnic group, our study suggests it may be elevated in black subjects under 65 years.…”

Section: Discussionmentioning

confidence: 99%

“…Race-ethnicity was based on self-identification. 13,14 MRI substudy NOMAS subjects were enrolled into the MRI substudy beginning in 2003 using the following criteria: 1) age older than 55, 2) no contraindications to MRI, and 3) signed informed consent. Imaging was performed on a 1.5T MRI system (Philips Medical Systems, Best, the Netherlands) at the Hatch Research Center.…”

Section: Patient Selection and Baseline Evaluationmentioning

confidence: 99%

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Prevalence and determinants of subclinical brain infarction

Wright¹,

Yoshita²,

DeLaPaz³

et al. 2008

Neurology

134

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Objective-Risk factors for subclinical brain infarcts (SBI) have not been well studied, especially in Hispanics and blacks who may be at higher risk for vascular disease. We examined the prevalence and determinants of SBI in a multi-ethnic community cohort. Methods-TheNorthern Manhattan Study (NOMAS) includes 892 stroke-free participants who underwent brain magnetic resonance imaging (MRI). Baseline demographic and vascular risk factor data were collected. The presence of SBI was determined from the size, location, and imaging characteristics of the lesion based on FLAIR, T1 and T2, and proton density MRI sequences. We calculated the prevalence of SBI and cross-sectional associations with socio-demographic and vascular risk factors, using logistic regression to adjust for relevant covariates.Results-Among 892 subjects (mean age 71.3 years), 158 (17.7%) had SBI (13.5% had 1 lesion, 4.3% had > 1 lesion). Of the total 216 infarcts, most were small (< 1 cm, 82.4%) and subcortical (82.9). SBI prevalence increased with age (< 65: 9.7%; 65-75: 16.4%; > 75: 26.1%), was increased among men (21.3% vs. 15.2% in women) and blacks (24.0% vs. 18.1% in whites and 15.8% in Hispanics). The presence of SBI was independently associated with older age (per year: OR 1.06, 95% CI 1.04-1.09), male sex (OR 1.79, 95% CI 1.22-2.61), and hypertension (OR 2.08, 95% CI 1.35-3.22) adjusting for age, sex, race-ethnicity, and vascular risk factors. A significant interaction (P = 0.002) between race and age was observed such that younger blacks had greater odds of having SBI.Conclusions-SBI were detected in nearly 18% of subjects in a multi-ethnic community-based cohort. Age, male sex, and hypertension were independently associated with SBI. Subclinical cerebral infarcts are more prevalent than symptomatic infarcts and may increase the true public health burden of stroke.

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Section: Discussionmentioning

confidence: 99%

Section: Patient Selection and Baseline Evaluationmentioning

confidence: 99%

Prevalence and determinants of subclinical brain infarction

Wright¹,

Yoshita²,

DeLaPaz³

et al. 2008

Neurology

134

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“…A third study found no difference in maximum internal carotid artery plaque thickness between blacks and whites. 30 A fluoroscopic study conducted in persons at high risk for coronary disease identified coronary calcium in only 36% of blacks compared with 60% of whites and Asian Americans. 31 This difference remained after adjustment for risk factors.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Correlates of Coronary Calcification in Black and White Young Adults

Bild

Folsom

Lowe

et al. 2001

ATVB

135

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Abstract-Whereas cardiovascular risk factor levels are substantially different in black and white Americans, the relative rates of cardiovascular disease in the 2 groups are not always consistent with these differences. To compare the prevalence of coronary calcification, an indicator of coronary atherosclerosis, in young adult blacks and whites, we performed electron-beam computed tomography of the heart in 443 men and women aged 28 to 40 years recruited from a population-based cohort. The presence of calcium, defined as at least 1 focus of at least 2.05 mm 2 in area and Ͼ130 Hounsfield units in density within the coronary arteries, was identified in 16.1% of black men, 11.8% of black women, 17.1% of white men, and 4.6% of white women (Pϭ0.04 for comparison across groups). Coronary calcium was associated with age and male sex, and after adjustment for age, race, and sex, coronary calcium was positively associated with body mass index, weight, systolic blood pressure, total cholesterol, low density lipoprotein cholesterol, triglycerides, and fasting insulin and negatively associated with education (all PϽ0.05). Independent risk factors included male sex, body mass index, and low density lipoprotein cholesterol. Race was not significantly associated with coronary calcium in men or women, before or after adjustment for risk factors. Coronary calcification is associated with increased levels of cardiovascular risk factors in young adults, and its prevalence is not significantly different in blacks and whites. Key Words: coronary heart disease Ⅲ risk factors Ⅲ race Ⅲ coronary artery calcification R elative levels of coronary risk factors in blacks and whites suggest that blacks would be at higher risk for coronary heart disease (CHD). 1-6 CHD mortality rates appear to reflect higher risk factor levels in blacks, 7 but CHD incidence is lower in black men than in white men. 8 Clues to possible racial differences in rates of CHD may be found by identifying subclinical disease for which treatment has not been instituted and which is not subject to the biases of disease ascertainment or death certificate coding. 9 -12 To compare the prevalence of a marker of coronary atherosclerosis in a population-based sample of young adult blacks and whites, to examine risk factor correlates, and to determine whether any racial differences in prevalence might be explained by risk factor differences, we measured coronary calcification by using electron-beam computed tomography (EBCT) of the heart and risk factors in men and women aged 28 to 40 years who have participated in an ongoing epidemiological study of the coronary disease risk factors. Coronary calcium is a specific marker for coronary atherosclerosis 13 and can be quantified by EBCT. 14 -16 Methods ParticipantsParticipants in the present study were from the Coronary Artery Risk Development in Young Adults (CARDIA) Study. The baseline CARDIA examination took place from 1985 to 1986 and included 5115 women and men from 4 centers (Birmingham, Ala; Chicago, Ill; Minneapolis, Min...

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“…For example, the ε4 allele of APOE is associated with an increase of low density lipoprotein cholesterol (LDL-C) levels by 2.6 mg/dL in Caucasian men but 8.5 mg/dL in Hispanic men [4,12]. Furthermore, an elevated LDL-C level leads to a more prominent progression in carotid atherosclerosis in Hispanics than other ethnic groups [13], suggesting that race-ethnicity may influence the relationship between genes, lipids and CVD risk.…”

Section: Introductionmentioning

confidence: 99%

Multiple genetic determinants of plasma lipid levels in Caribbean Hispanics

Liao

Lin

Rundek

et al. 2008

Clinical Biochemistry

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Objectives: To identify candidate genes in relation to plasma lipid levels in Caribbean Hispanics. Design and methods:A total of 114 single nucleotide polymorphisms (SNPs) at 17 lipid-related genes were genotyped in 477 Caribbean Hispanics from the Northern Manhattan Study (NOMAS). Analyses for each SNP and haplotype were performed to evaluate the associations with four lipid traits: high-and low-density lipoprotein cholesterol (HDL-C, LDL-C), triglyceride (TG) and total cholesterol (TC). Results:We identified 19 SNPs at 10 genes that were significantly related to lipids (p<0.01), including nine involved in the reverse cholesterol transport pathway, and one involved in bile acid synthesis. Three genes, namely the apolipoprotein A5, apolipoprotein B and cytochrome p450 polypeptide 7A1 genes, accounted for the largest proportion of variation in HDL-C/TG, TC and LDL-C respectively. Conclusions:The cumulative effects of multiple genetic variants led to a substantially better prediction of inter-individual variations in lipid levels.

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Race-Ethnicity and Determinants of Carotid Atherosclerosis in a Multiethnic Population

Abstract: Atherosclerotic risk factors were predictive of MICPT in this mixed-ethnic cohort. Hispanics had significantly less carotid plaque after adjustment for other known risk factors, but they also had a greater impact of increasing LDL cholesterol.

Cited by 146 publications

References 38 publications

Prevalence and determinants of subclinical brain infarction

Prevalence and determinants of subclinical brain infarction

Prevalence and Correlates of Coronary Calcification in Black and White Young Adults

Multiple genetic determinants of plasma lipid levels in Caribbean Hispanics

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