Racial disparity in microvascular function among non‐Hispanic white and non‐Hispanic black men with newly diagnosed prostate cancer

Cardiovascular disease (CVD) is a leading cause of mortality in men with prostate cancer (PC), with non-Hispanic Black (NHB) men experiencing disproportionately higher CVD-related mortality compared to non-Hispanic White (NHW) men. Vascular endothelial dysfunction precedes overt CVD; however, the mechanisms underlying racial disparities in CVD among men with PC remain unclear. This study tested the hypothesis that NHB men with PC would exhibit impaired vascular health compared to NHW men. Thirty-four men (12 NHW and 22 NHB) with a clinical diagnosis of PC underwent comprehensive vascular assessment, including arterial stiffness (pulse wave velocity [PWV] and augmentation index at 75 bpm [AIx75]), conduit-vessel endothelial function (flow-mediated dilation [FMD]), and microvascular function (post-occlusive reactive hyperemia [PORH], local thermal heating [LTH], and acetylcholine iontophoresis). Clinical laboratory values, senescence-associated secretory phenotype (SASP), and allostatic load were also evaluated. NHW men were older (p = 0.050), with no differences in body mass index (BMI), laboratory values, allostatic load, or SASP (all p > 0.05). NHB men demonstrated significantly lower PORH, LTH, and acetylcholine responses (all p < 0.001), while PWV, AIx75, and FMD were similar between groups. Despite comparable conduit-vessel and arterial stiffness measures, NHB men exhibited impaired microvascular function, suggesting racial differences in vascular bed-specific dysfunction following PC diagnosis.