Insulin Resistance and Cardiovascular Disease Risk in Black People of the African Diaspora

Abstract

Insulin resistance plays a pivotal role in the development of cardiovascular disease (CVD) in whites. Insulin resistance syndrome includes a constellation of diseases such as hyperglycemia, obesity, hypertension, hypertriglyceridemia, and low high-density lipoprotein cholesterol. Black People of the African Diaspora (PAD) have greater rates of insulin resistance than whites, but the association of insulin resistance to CVD in black PAD is controversial. Moreover, among black PAD, the relationship of insulin resistance with coronary artery disease varies depending on geographic location. In general, in black PAD there is emerging evidence that indicates increases in the incidence of CVD mortality and morbidity are attributable predominately to hypertension and lifestyle. Overall, the higher CVD in black PAD occurs even though their characteristic lipid/lipoprotein profile is antiatherogenic. This review provides a critical examination of the role of insulin resistance in the development of CVD in black PAD and compares and contrasts insulin resistance, the lipid/ lipoprotein profile, and blood pressure in black PAD and whites.

Metabolic Syndrome Indicators and Target Organ Damage in Urban Active Coping African and Caucasian Men: The SABPA Study

“…Furthermore, their total cholesterol concentrations were higher and HDL-C concentrations lower than those of their African counterparts. In accord with the THUSA study, we found more dyslipidaemia in the high AC Caucasian men ( Oosthuizen et al, 2002 ), but in contrast to literature, subclinical atherosclerosis was associated with dyslipidaemia in the high AC African men, who supposedly have less atherogenic lipid profi les than Caucasians ( Gaillard, 2010, Budoff et al, 2006. Augmented hs-CRP concentrations were reported to indicate a low-grade infl ammation in Africans ( Ntyintyane et al, 2009 ), and it has been found that African Americans have higher hs-CRP concentrations ( Watson and Topol, 2004 ), which may also be true for Africans in South Africa.…”

Blunted neuroendocrine responses linking depressive symptoms and ECG-left ventricular hypertrophy in black Africans

“…These findings may have important health implications given the emerging burden of CVD among urban black Africans and the fact that a three-fold risk of depressive symptoms has been observed in this population group in comparison with white Africans [6,13]. When coupled to their hypertensive status, these vasoconstrictive agent responses may underpin the increased long-term depression and vascular disease risk in urban Africans.…”

Ethnicity, obesity and the metabolic syndrome: implications on assessing risk and targeting intervention

“…This increased prevalence is thought to be due to both genetic and environmental factors [65], although during adulthood the increased prevalence continues even after adjustment for lifestyle factors, suggesting that genetic factors may predominate [22]. Children and adults of Hispanic heritage are less likely to have hypertension, a tendency that may suggest underlying genetic causes, as it also persists even after adjustment for lifestyle factors [22].…”

“…Children and adults of Hispanic heritage are less likely to have hypertension, a tendency that may suggest underlying genetic causes, as it also persists even after adjustment for lifestyle factors [22]. However, the clinical significance of these ethnic differences and their relationship with MetS is unclear, given that blood pressure has been frequently shown to have the weakest association with insulin resistance among MetS components [65,66]. …”