The Effect of Ethnicity on the Relationship Between Premature Coronary Artery Disease and Traditional Cardiac Risk Factors Among Uninsured Young Adults

Amin, Amit P.; Nathan, Sandeep; Evans, Arthur T.; Attanasio, Steve; Mukhopadhyay, Ekanka; Mehta, Vijay; Kelly, Russell F.

doi:10.1111/j.1751-7141.2009.00025.x

Cited by 13 publications

(12 citation statements)

References 18 publications

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“…These results were found in a retrospective cohort study of all patients 40 years or younger who underwent coronary angiography at a Cook County Hospital in Chicago that serves a mostly uninsured, minority population [10]. Asian Indians have high mortality from CHD, especially in the youngest age cohort.…”

Section: Burden Of Cardiovascular Diseasesupporting

confidence: 55%

“…This high risk was in spite of Asian Indians having a lower prevalence of risk factors such as hypertension, dyslipidemia, and smoking in this population. In the multivariate predictors of CAD, Asian Indian ethnicity conferred an odds ratio of 2.7 as compared to blacks, who were the reference group [10]. Thus, from prevalence and mortality data it is evident that Asian Indians have disproportionately higher burden of premature CVD.…”

Section: Burden Of Cardiovascular Diseasementioning

confidence: 96%

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Cardiovascular Disease in Asian Indians Living in the United States

Boparai

Davila

Chandalia

2011

Curr Cardiovasc Risk Rep

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Asian Indians (people originating from the Indian subcontinent) are the largest Asian subgroup in the United States and one of the fastest growing ethnic groups as well, with the population projected to increase to 41 million by 2050. Prevalence of cardiovascular disease is significantly higher in Asian Indians compared to whites living in the United States. Asian Indians have a high risk of premature coronary artery disease and have high mortality from coronary heart disease, especially in the youngest age cohort. The factors for increased cardiovascular risk include the high prevalence of diabetes and insulin resistance, increased truncal fat distribution, and atherogenic lipoprotein profiles. When adjusted for age, sex, and body mass index, Asian Indians have the highest ethnic-specific prevalence of diabetes compared to whites, African Americans, Hispanics, and Native Americans. Among the lifestyle risk factors, prevalence of leisure time physical inactivity is reported to be higher among Asian Indians, and rates of smoking, obesity, and binge drinking are much lower compared to European populations. With the increasing affluence of Asian Indians living in United States and decreasing work-related physical activity, the lack of leisure time physical activity may become a major contributor to metabolic abnormalities in this population. The presence of excess insulin resistance, dyslipidemia, metabolic syndrome, and lower plasma adiponectin concentration at lower total body fat in Asian Indians points to adipose tissue dysfunction. Although there is a public health need for early assessment of cardiovascular risk factors in this high-risk cohort and aggressive intervention to modify these factors with development of culturally tailored interventions to promote leisure time physical activity and healthy dietary habits, further research to identify targets for early diagnosis and intervention other than traditional approaches is warranted.

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Section: Burden Of Cardiovascular Diseasesupporting

confidence: 55%

Section: Burden Of Cardiovascular Diseasementioning

confidence: 96%

Cardiovascular Disease in Asian Indians Living in the United States

Boparai

Davila

Chandalia

2011

Curr Cardiovasc Risk Rep

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“…While smoking was the only factor impacting CVD in Whites, diabetes and dyslipidemia were also independently associated in Blacks. (45) There are also investigations that identify racial differences with regard to the metabolism of nicotine. Blacks are known to have a 30% higher intake of nicotine per cigarette than Whites and have a slower clearance of nicotine metabolites.…”

Section: Discussionmentioning

confidence: 99%

The relationship between race, cigarette smoking and carotid intimal medial thickness in systemic lupus erythematosus

Scalzi

Bhatt

Gilkeson

et al. 2009

Lupus

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Objective Racial differences are known to account for a higher incidence of systemic lupus erythematosus (SLE), as well as increased disease severity and mortality. The purpose of this study was to determine if there are any race-specific risk factors that affect measures of subclinical atherosclerosis in SLE patients. Methods Traditional and SLE-related cardiovascular disease (CVD) risk factors were assessed in 106 female SLE patients. Carotid medial intimal medial thickness (mIMT) and coronary artery calcification (CAC) were measured on all subjects. Differences were evaluated between races for all clinical, serologic, and CVD risk factors and the racial interactions with all covariables. Outcomes included mIMT and CAC. Results There were no significant differences between races with regard to mIMT or CAC. Significant covariables in the final model for mIMT included age, triglycerides, glucose, and race-age and race-smoking interactions. A prediction model with fixed significant covariables demonstrated that Black subjects with a smoking history had a significantly higher mIMT than Blacks who had never smoked, an effect not seen in Whites. There were no differences between having CAC or with the CAC scores between the races. In the final model for CAC, age and SLE disease duration were significant covariables impacting CAC. Conclusion When controlling for other significant CVD covariables and interactions, Black women, but not White, with SLE with a history of smoking have higher mIMT measurements than those who have never smoked. This is the first report documenting the race-specific effect of smoking on subclinical measures of CVD in SLE.

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“…378 The prevalence of premature CAD (<40 years old) appears to be lower in the Hispanic population (20%) than among NHBs (30%) and NHWs (50%). 377 HCHS/SOL found self-reported CHD prevalence for Hispanic men and women of 4.2% and 2.4%, respectively. 1 Puerto Ricans reported the highest prevalence of CHD (5.0%) compared with other Hispanic subgroups.…”

Section: Hispanic Cvd Incidence and Prevalencementioning

confidence: 98%

“…376 The prevalence of angiographic CAD among Hispanics aged ≥40 years ranged from 10% for those without CVD risk factors to 70% for those who had a history of diabetes mellitus, smoking, and dyslipidemia. 377 In a cohort of patients referred for angiography (in the ACC-NCDR, or American College of Cardiology–National Cardiovascular Data Registry), Hispanic women had lower rates of significant CAD (45.3%) than NHWs (59%) and slightly higher rates than NHBs (41.7%). 378 The prevalence of premature CAD (<40 years old) appears to be lower in the Hispanic population (20%) than among NHBs (30%) and NHWs (50%).…”

Section: Hispanic Cvd Incidence and Prevalencementioning

confidence: 99%

Status of Cardiovascular Disease and Stroke in Hispanics/Latinos in the United States

Rodríguez¹,

Allison²,

Daviglus³

et al. 2014

Circulation

308

288

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Background and Purpose This American Heart Association (AHA) scientific statement provides a comprehensive overview of current evidence on the burden cardiovascular disease (CVD) among Hispanics in the United States. Hispanics are the largest minority ethnic group in the United States, and their health is vital to the public health of the nation and to achieving the AHA’s 2020 goals. This statement describes the CVD epidemiology and related personal beliefs and the social and health issues of US Hispanics, and it identifies potential prevention and treatment opportunities. The intended audience for this statement includes healthcare professionals, researchers, and policy makers. Methods Writing group members were nominated by the AHA’s Manuscript Oversight Committee and represent a broad range of expertise in relation to Hispanic individuals and CVD. The writers used a general framework outlined by the committee chair to produce a comprehensive literature review that summarizes existing evidence, indicate gaps in current knowledge, and formulate recommendations. Only English-language studies were reviewed, with PubMed/MEDLINE as our primary resource, as well as the Cochrane Library Reviews, Centers for Disease Control and Prevention, and the US Census data as secondary resources. Inductive methods and descriptive studies that focused on CVD outcomes incidence, prevalence, treatment response, and risks were included. Because of the wide scope of these topics, members of the writing committee were responsible for drafting individual sections selected by the chair of the writing committee, and the group chair assembled the complete statement. The conclusions of this statement are the views of the authors and do not necessarily represent the official view of the AHA. All members of the writing group had the opportunity to comment on the initial drafts and approved the final version of this document. The manuscript underwent extensive AHA internal peer review before consideration and approval by the AHA Science Advisory and Coordinating Committee. Results This statement documents the status of knowledge regarding CVD among Hispanics and the sociocultural issues that impact all subgroups of Hispanics with regard to cardiovascular health. In this review, whenever possible, we identify the specific Hispanic subgroups examined to avoid generalizations. We identify specific areas for which current evidence was less robust, as well as inconsistencies and evidence gaps that inform the need for further rigorous and interdisciplinary approaches to increase our understanding of the US Hispanic population and its potential impact on the public health and cardiovascular health of the total US population. We provide recommendations specific to the 9 domains outlined by the chair to support the development of these culturally tailored and targeted approaches. Conclusions Healthcare professionals and researchers need to consider the impact of culture and ethnicity on health behavior and ultimately health outcomes. There is a...

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The Effect of Ethnicity on the Relationship Between Premature Coronary Artery Disease and Traditional Cardiac Risk Factors Among Uninsured Young Adults

Cited by 13 publications

References 18 publications

Cardiovascular Disease in Asian Indians Living in the United States

Cardiovascular Disease in Asian Indians Living in the United States

The relationship between race, cigarette smoking and carotid intimal medial thickness in systemic lupus erythematosus

Status of Cardiovascular Disease and Stroke in Hispanics/Latinos in the United States

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