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Cardiovascular risk greater among black women with RA than Caucasian women in Africa
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Compared with Caucasian women, black women with rheumatoid arthritis in Africa experienced an increased metabolic cardiovascular risk factor burden that was not associated with atherosclerosis, according to study results.
Researchers examined the relationships of metabolic syndrome (MetS) and its components with carotid artery atherosclerosis in 197 women with rheumatoid arthritis (RA) in Johannesburg, South Africa. They included 104 women (mean age, 55.4 years) from a developing black population and 93 women (mean age, 57.3 years) from a developed Caucasian population. Patients were recruited from a private hospital and a public hospital and excluded those known to be infected with HIV. Approximately 97% of black patients were seen in public care; 83% of Caucasians were seen privately (P<.0001).
Researchers found the following trends:
- The number of MetS criteria was significantly greater in blacks compared with Caucasians. They included prevalence (30.8% vs. 9.7%; adjusted OR=10.11; 95% CI, 1.76-58.03) and HDL-cholesterol (21.2% vs. 15.1%; aOR=6.14; 95% CI, 1.11-33.92).
- Metabolic risk factors and atherosclerosis relationships were impacted by population origin.
- MetS was associated with carotid artery intima-media thickness (cIMT; P=.036) in the Caucasian cohort, and MetS triglycerides and the number of MetS criteria also were associated with cIMT (P=.01 and P=.028, respectively) and carotid artery plaque (P=.049 and P=.02, respectively).
- MetS blood pressure was related to cIMT among the black cohort (P=.04).
“In contrast to their African Caucasian counterparts, black women with RA experience a markedly increased metabolic risk factor burden that is … as yet not likely to be associated with atherosclerosis,” the researchers concluded. “The potential role of metabolic risk factors in atherogenesis in African black women with RA requires further assessment in longitudinal studies.
“Since the atherosclerosis extent was not reduced in African black women compared to Caucasian women … our findings call for systematic cardiovascular risk management irrespective of metabolic risk factor profiles in African black women with RA.”
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