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Dissociation Between Cardiovascular Risk Markers and Clinical Outcomes in African Americans: Need for Greater Mechanistic Insight

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Abstract

Despite having distinct advantages, such as lower serum triglycerides, higher high-density lipoprotein (HDL) cholesterol levels, and less visceral adiposity, African Americans suffer disproportionately from cardiovascular disease (CVD). In African Americans, attention often focuses on two cardiometabolic risk factors—hypertension and type 2 diabetes mellitus—because they occur more frequently in African Americans than whites. Exactly how hypertension and hyperglycemia appear to override benefits from the lower prevalence of dyslipidemia and other factors is unknown. From a practical viewpoint, as the combined effects of hypertension and type 2 diabetes mellitus are dominant, then primary prevention with vigorous control of these conditions must be of utmost priority. However, because attention is focused on hypertension and type 2 diabetes mellitus, the role of other potential risk factors, such as low-density lipoprotein cholesterol oxidation, HDL cholesterol function, lipoxygenase pathway, endothelial progenitor cells, and natriuretic peptide regulation, have not been well studied. In this review, we discuss the paradox of CVD morbidity and mortality among African Americans and offer suggestions for future investigation.

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Acknowledgment

Samuel Dagogo-Jack is supported in part by National Institutes of Health Grants R01 DK067269 and MO1 RR00211.

Disclosure

Samuel Dagogo-Jack has received grants from AstraZeneca, Bristol-Myers Squibb, and Novo Nordisk. He has received honoraria from Eli Lilly, GlaxoSmithKline, Merck, and Roche. Ibiayi Dagogo-Jack reports no potential conflict of interest relevant to this article.

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Authors and Affiliations

  1. Pritzker School of Medicine, University of Chicago, Chicago, IL, USA

    Ibiayi Dagogo-Jack

  2. Division of Endocrinology, Diabetes & Metabolism, University of Tennessee Health Science Center, 920 Madison Avenue, Suite 300A, Memphis, TN, 38163, USA

    Samuel Dagogo-Jack

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  1. Ibiayi Dagogo-Jack
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Correspondence to Samuel Dagogo-Jack.

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Dagogo-Jack, I., Dagogo-Jack, S. Dissociation Between Cardiovascular Risk Markers and Clinical Outcomes in African Americans: Need for Greater Mechanistic Insight. Curr Cardiovasc Risk Rep 5, 200–206 (2011). https://doi.org/10.1007/s12170-011-0160-x

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