African Americans cardiovascular disease

Hypertension is a sustained, reproducible increase in blood pressure. Hypertension is one of the most common diseases affecting adults living in industrialized nations. In the United States, for example, hypertension occurs in approximately 30% of the general population aged 20 and over.44 The prevalence of this disease can be even higher in certain subpopulations (e.g., 41% in African Americans), and the incidence of hypertension increases with age.44,45 If left untreated, the sustained increase in blood pressure associated with hypertension can lead to cardiovascular problems (stroke, heart failure), renal disease, and blindness.15,22 108 111 These and other medical problems ultimately lead to an increased mortality rate in hypertensive individuals. 

In a study at the University of North Carolina involving about nine thousand men and women over a period of 11.6 years, the rate of cardiovascular disease increased significantly as blood pressure levels increased. Compared with patients who had optimal blood pressure levels, those with high-normal measurements had two and a half times the risk of developing cardiovascular disease. That statistic took into consideration other factors involved in the disease. Most of the risk was in the form of a stroke. The risk was greatest for African Americans, diabetics, overweight and obese individuals, and people with high levels of LDL cholesterol. 

Bakris G, Rahman M, Lea J, et al. Associations between cardiovascular risk factors and glomerular filtration rate at baseline in the African American Study of Kidney Disease (AASK) trial. J Am Soc Nephrol 1998 10 A0717. 

Apo(a) is a protein found covalently linked to apo-BlOO in some LDL particles. Those LDL particles to which apo(a) is attached are called lipoprotein(a) oxLp(a). Plasma levels ofLp(a) correlate with increased cardiovascular disease risk in most populations, but not in African-Americans. The level of Lp(a) appears to be entirely genetically determined. The Lp(a) concentration is almost entirely related to the particular alleles of the Lp(a) gene expressed by an individual. 

The Indianapolis-Ibadan Dementia Project also demonstrated the reverse side of the coin, and this too was passed off with little comment the mortality rate in the African cohort was nearly double that of the American cohort, despite their better cardiovascular health. What they died of is not stated. I imagine many must have died from infections or cancers. Studies in Tanzania, where malaria is also endemic, showed that the death rate fell substantially in regions where malaria had been controlled by draining swamps. The scale of this effect was larger than could be attributed directly to malaria, and prompted research into the hidden morbidity of malaria. This research has confirmed the suspicions immuno-suppression in areas where malaria is endemic perpetuates opportunistic infections, leading to the spread of diseases such as tuberculosis. In addition, cancers such as Burkitt s lymphoma (a malignant cancer of B cells) are common and linked with malarial immunosuppression, probably... 

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