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Black adults without metabolic syndrome still at risk for vascular disease
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Black adults without metabolic syndrome have worse vascular function when compared with whites, indicating that the consensus definition of the disease may not capture the increased underlying risk that varies by race, according to research in The Journal of Clinical Endocrinology & Metabolism.
In a biracial, community-based sample, researchers also found that accounting for the presence of hypertension in blacks as an added risk factor for metabolic syndrome improved the association between metabolic syndrome and vascular dysfunction in black adults.
“When hypertension in [black] subjects was given a score of two (instead of one) [metabolic syndrome] components, 70 additional [black] subjects without [metabolic syndrome] were reclassified as having [metabolic syndrome],” the researchers wrote.
Jia Shen, MD, MPH, a clinical research fellow at Emory Clinical Cardiovascular Research Institute, and colleagues analyzed data from 951 black and white participants aged 20 to 90 years (mean age, 49 years; 47% black; 55% women) recruited from 2005 to 2009. Researchers measured reactive hyperemia index, as well as central augmentation index and pulse wave velocity, as indicators of microvascular endothelial function, wave reflections and arterial stiffness, respectively.
Researchers found that 26.9% of black participants had metabolic syndrome vs. 21.4% of white participants. In participants without metabolic syndrome, black participants had a lower reactive hyperemia index, a higher pulse wave velocity and higher central augmentation index compared with white participants.
The addition of an extra metabolic syndrome criterion point for blacks with hypertension eliminated the racial differences in pulse wave velocity and central augmentation index, but not for reactive hyperemia index, according to researchers.
“Whereas there was no significant difference in the [reactive hyperemia index] between [blacks] and whites diagnosed with [metabolic syndrome], in those without [metabolic syndrome], [reactive hyperemia index] remained significantly lower in [blacks] compared with whites,” the researchers wrote. “In a multivariate analysis that included all univariate predictors of RHI, only race remained an independent predictor of RHI.”
Researchers said additional studies are needed to determine whether similar weighting will lead to better identification of blacks at risk for clinical cardiovascular disease and its adverse events. – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.
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