Key result
Black race was associated with differences in cardiovascular biomarkers, and adjusting for these attenuated the higher risk of CVD events in black men (adjusted HR 1.21) and women (adjusted HR 1.15).
Why the study?
CVD incidence and manifestations differ between blacks and whites, and pathophysiological biomarkers may provide insight into these racial differences.
Do cardiovascular biomarkers differ between black and white individuals and explain racial differences in CVD risk?
Observational (n=2,635)
Do cardiovascular biomarkers differ between black and white individuals and explain racial differences in CVD risk?
Significant racial differences exist in multiple cardiovascular biomarkers, which may largely explain the higher risk of CVD events observed in black compared to white individuals.
Biomarker differences may partly explain racial CVD disparities; observational data leave open causal roles and intervention targets.
Background The incidence and clinical manifestations of cardiovascular disease (CVD) differ between blacks and whites. Biomarkers that reflect important pathophysiological pathways may provide a window to allow deeper understanding of racial differences in CVD. Methods and Results The study included 2635 white and black participants from the Dallas Heart Study who were free from existing CVD. Cross-sectional associations between race and 32 biomarkers were evaluated using multivariable linear regression adjusting for age, traditional CVD risk factors, imaging measures of body composition, renal function, insulin resistance, left ventricular mass, and socioeconomic factors. In fully adjusted models, black women had higher lipoprotein(a), leptin, d-dimer, osteoprotegerin, antinuclear antibody, homoarginine, suppression of tumorigenicity-2, and urinary microalbumin, and lower adiponectin, soluble receptor for advanced glycation end products and N-terminal pro-B-type natriuretic peptide versus white women. Black men had higher lipoprotein(a), leptin, d-dimer, high-sensitivity C-reactive protein, antinuclear antibody, symmetrical dimethylarginine, homoarginine, high-sensitivity cardiac troponin T, suppression of tumorigenicity-2, and lower adiponectin, soluble receptor for advanced glycation end products, and N-terminal pro-B-type natriuretic peptide versus white men. Adjustment for biomarkers that were associated with higher CVD risk, and that differed between blacks and whites, attenuated the risk for CVD events in black women (unadjusted hazard ratio 2.05, 95% CI 1.32, 3.17 and adjusted hazard ratio 1.15, 95% CI 0.69, 1.92) and black men (unadjusted hazard ratio 2.39, 95% CI 1.64, 3.46, and adjusted hazard ratio 1.21, 95% CI 0.76, 1.95). Conclusions Significant racial differences were seen in biomarkers reflecting lipids, adipokines, and biomarkers of endothelial function, inflammation, myocyte injury, and neurohormonal stress, which may contribute to racial differences in the development and complications of CVD.
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Hackler et al. (2019) conducted an observational in free from existing CVD (n=2,635). Black race vs. White race was evaluated on CVD events (HR 1.21, 95% CI 0.76-1.95). Black race was associated with differences in cardiovascular biomarkers, and adjusting for these attenuated the higher risk of CVD events in black men (adjusted HR 1.21) and women (adjusted HR 1.15).
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