Institut de Cardiologie de Montréal, Montréal, Quebec, Canada.
Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Hospital Universitario Clínico San Carlos, Madrid, Spain; CIBER de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain.
J Am Coll Cardiol. 2022 Jul 19;80(3):219-229. doi: 10.1016/j.jacc.2022.04.054.
Non-Hispanic Black persons are at greater risk of cardiovascular (CV) events than other racial/ethnic groups; however, their differential vulnerability to early subclinical atherosclerosis is poorly understood.
This work aims to study the impact of race/ethnicity on early subclinical atherosclerosis in young socioeconomically disadvantaged adults.
Bilateral carotid and femoral 3-dimensional vascular ultrasound examinations were performed on 436 adults (parents/caregivers and staff) with a mean age of 38.0 ± 11.1 years, 82.3% female, 66% self-reported as Hispanic, 34% self-reported as non-Hispanic Black, and no history of CV disease recruited in the FAMILIA (Family-Based Approach in a Minority Community Integrating Systems-Biology for Promotion of Health) trial from 15 Head Start preschools in Harlem (neighborhood in New York, New York, USA). The 10-year Framingham CV risk score was calculated, and the relationship between race/ethnicity and the presence and extent of subclinical atherosclerosis was analyzed with multivariable logistic and linear regression models.
The mean 10-year Framingham CV risk was 4.0%, with no differences by racial/ethnic category. The overall prevalence of subclinical atherosclerosis was significantly higher in the non-Hispanic Black (12.9%) than in the Hispanic subpopulation (6.6%). After adjusting for 10-year Framingham CV risk score, body mass index, fruit and vegetable consumption, physical activity, and employment status, non-Hispanic Black individuals were more likely than Hispanic individuals to have subclinical atherosclerosis (OR: 3.45; 95% CI: 1.44-8.29; P = 0.006) and multiterritorial disease (P = 0.026).
After adjustment for classic CV risk, lifestyle, and socioeconomic factors, non-Hispanic Black younger adults seem more vulnerable to early subclinical atherosclerosis than their Hispanic peers, suggesting that the existence of emerging or undiscovered CV factors underlying the residual excess risk (Family-Based Approach in a Minority Community Integrating Systems-Biology for Promotion of Health [FAMILIA (Project 2)]; NCT02481401).
非西班牙裔黑人患心血管（CV）事件的风险高于其他种族/族裔群体；然而，他们早期亚临床动脉粥样硬化的易感性差异尚未得到充分理解。
本研究旨在探讨种族/族裔对年轻社会经济弱势群体中早期亚临床动脉粥样硬化的影响。
对来自美国纽约哈莱姆区（纽约市的一个社区） 15 家“先普乐”（Head Start）学前学校的 436 名平均年龄为 38.0±11.1 岁的成年人（父母/看护人和工作人员）进行了双侧颈动脉和股动脉三维血管超声检查，其中 82.3%为女性，66%自我报告为西班牙裔，34%自我报告为非西班牙裔黑人，且无心血管疾病史。使用Framingham CV 风险评分模型计算了 10 年Framingham CV 风险评分，并使用多变量逻辑和线性回归模型分析了种族/族裔与亚临床动脉粥样硬化的存在和程度之间的关系。
平均Framingham 10 年 CV 风险为 4.0%，不同种族/族裔间无差异。非西班牙裔黑人（12.9%）的亚临床动脉粥样硬化总体患病率明显高于西班牙裔人群（6.6%）。在校正了Framingham 10 年 CV 风险评分、体重指数、水果和蔬菜摄入量、身体活动和就业状况后，非西班牙裔黑人比西班牙裔个体更有可能发生亚临床动脉粥样硬化（比值比：3.45；95%置信区间：1.44-8.29；P=0.006）和多部位疾病（P=0.026）。
在校正了经典心血管风险、生活方式和社会经济因素后，非西班牙裔黑人年轻成年人似乎比他们的西班牙裔同龄人更容易发生早期亚临床动脉粥样硬化，这表明在剩余的风险中存在新兴或未被发现的心血管因素（基于社区的少数族裔综合系统生物学促进健康方法[FAMILIA（项目 2）]；NCT02481401）。
