Coronary heart disease risk factors in premenopausal black women compared to white women Public Deposited

http://ir.library.oregonstate.edu/concern/graduate_thesis_or_dissertations/41687m324

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  • Background: Premenopausal black women have a 2-3 fold greater rate of coronary heart disease (CHD) than premenopausal white women. The purpose of this study was to provide insight into the reasons for this difference. Methods and Results: We compared CHD risk factors in 100 black and 100 white, healthy premenopausal women age 18-45 years and of relatively advantaged socioeconomic status. Black women consumed diets higher in saturated fat and cholesterol (12% of kcal as saturated fat and 360 mg of cholesterol per day) than did white women (10% of kcal and 290 mg/day) (p=0.008). Black women also had a higher body mass index (BMI) (32.0±9.2 vs. 29.0±9.4 kg/m², p=0.021), and higher systolic (124±17 vs. 115±14 mmHg, p<0.0001), and diastolic (79±14 vs. 75±11 mmHg, p=0.048) blood pressures. The mean plasma Lp(a) concentration was higher in the black women (40.2±31.3 mg/dl) than in the white women (19.2±23.7 mg/dl)(p<0.0001). The black women, however, had lower plasma triglyceride levels (0.91±0.46 vs. 1.22±0.60 mmol/L, p<0.0001), and a trend toward higher HDL cholesterol levels (1.37±0.34 vs. 1.29±0.31 mmol/L, p=0.064) than the white women. Plasma total and LDL cholesterol levels were similar. Rates of cigarette smoking and alcohol intake were low and similar between the races. Black women additionally had higher levels of plasma total homocysteine (8.80 vs. 7.81 μmol/L, p=0.013), lower plasma folates (3.52 vs. 5.23 ng/ml, p<0.0001), and higher vitamin B₁₂ levels (522 vs. 417 pg/ml, p<0.0001) than white women. More white women than black women took a multivitamin supplement (42.4% vs. 24.7%, p=0.019). When adjusted for multivitamin use, homocysteine levels did not differ, but plasma folate remained significantly lower in black women. Sixty-eight percent of black women carried the wild-type methylenetetrahydrofolate reductase genotype, 32.0% were heterozygotes, and none were homozygotes. Of the white women, 47.4% were wild-type, 40.3% heterozygotes, and 12.3% homozygotes (p=0.013). Conclusions: Premenopausal black women consumed more saturated fat and cholesterol and had a higher mean body mass index, blood pressure, Lp(a), and plasma total homocysteine levels than white women. These differences in coronary risk factors may explain the higher incidence of CHD in premenopausal black compared to white women.
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  • description.provenance : Made available in DSpace on 2012-03-07T21:50:55Z (GMT). No. of bitstreams: 1 GERHARDGLENN1997.pdf: 5408934 bytes, checksum: e0b7800c4ae6fdab454151353c9a3df1 (MD5) Previous issue date: 1997-08-04
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  • description.provenance : Approved for entry into archive by Patricia Black(patricia.black@oregonstate.edu) on 2012-03-07T21:50:55Z (GMT) No. of bitstreams: 1 GERHARDGLENN1997.pdf: 5408934 bytes, checksum: e0b7800c4ae6fdab454151353c9a3df1 (MD5)
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