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ATHEROSCLEROSIS

African Americans and Caucasians have a similar prevalence of coronary calcium in the Dallas Heart Study

Tulika Jain, MD^*, Ronald Peshock, MD^*, Darren K. McGuire, MD, MHSc^*, DuWayne Willett, MD^*, Zhoazia Yu, MS, Gloria L. Vega, PhD^*, Rudy Guerra, PhD, Helen H. Hobbs, MD^*,, Scott M. Grundy, MD, PhD^*,* the Dallas Heart Study Investigators

^* Donald W. Reynolds Cardiovascular Clinical Research Center and the Department of Internal Medicine, Dallas, TexasUSA
Howard Hughes Medical Institute, University of Texas Southwestern Medical Center, Dallas, TexasUSA
Department of Statistics, Rice University, Houston, TexasUSA

Manuscript received January 21, 2004; revised manuscript received April 20, 2004, accepted May 19, 2004.

^* Reprint requests and correspondence: Dr. Scott M. Grundy, Center for Human Nutrition, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Room Y3206, Dallas, Texas 75390-9052 (Email: scott.grundy{at}utsouthwestern.edu).

OBJECTIVES: We sought to compare the prevalence of coronary atherosclerosis in a cohort of middle-age African American (black) and non-Hispanic Caucasian (white) men and women from a population-based probability sample.

BACKGROUND: Blacks have a higher mortality from coronary heart disease (CHD) than whites, particularly among younger individuals, and yet several studies have reported that coronary atherosclerosis is less prevalent in blacks than in whites. Data from population-based samples comparing coronary atherosclerotic burden between blacks and whites are limited.

METHODS: The prevalence of coronary atherosclerosis in middle-aged blacks and whites was determined using coronary calcium measured by electron beam computed tomography in 1,289 men and women from a population-based probability sample from Dallas, Texas.

RESULTS: The population estimates of the frequency of a positive scan for coronary artery calcium were not statistically different between black and white men (37% vs. 41%, p = 0.36) or between black and white women (29% vs. 23%, p = 0.21). Although the prevalence of most of the coronary risk factors varied significantly between blacks and whites, mean Framingham coronary risk factor scores were identical in black and white men (10 ± 4) but significantly higher in black women (13 ± 4) than in white women (12 ± 4).

CONCLUSIONS: Blacks in the general population have a prevalence of coronary atherosclerosis similar to whites. Factors other than coronary atherosclerotic burden, which are not reflected in the Framingham risk score, contribute significantly to the higher CHD mortality rate in blacks.

Abbreviations and Acronyms   BMI = body mass index   BP = blood pressure   CAC = coronary artery calcium   CARDIA = Coronary Artery Risk Development In young Adults study   CHD = coronary heart disease   DHS = Dallas Heart Study   EBCT = electron beam computed tomography   HDL = high-density lipoprotein   LDL = low-density lipoprotein   NCEP = National Cholesterol Education Program

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