| The contribution of hypertension to black-white differences in likelihood of coronary artery disease detected during elective angiography. | |
| | |
MedLine Citation:
|
PMID: 21088671 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Black patients in the United States undergoing angiography for suspected coronary artery disease (CAD) have consistently been found to have less disease than whites. As the effects of hypertension are greater in blacks than whites, and hypertensive heart disease may mimic CAD and lead to catheterization, we examined the association between race and hypertension as an explanation for the disparities in angiographic CAD. METHODS: Using an academic hospital's institutional database, we studied patients undergoing first-time elective angiography from 2001 to 2008. Using multivariable logistic regression with data on patient demographics, CAD risk factors, and coronary stenoses, we compared rates of angiographic disease for blacks and whites, creating models separately for patients with and without hypertension. We then tested the significance of an interaction term between race and hypertension on angiographic findings. RESULTS: We identified 1,203 black and 2,538 white patients who underwent initial elective angiography. Black patients were less likely to have a significant stenotic lesion (≥50% stenosis in the left main artery or ≥70% stenosis elsewhere) than whites (adjusted risk ratio 0.65; 95% confidence interval (CI) 0.55-0.75). Among patients with hypertension this difference was exaggerated (adjusted risk ratio 0.60; 95% CI 0.51-0.71). However, among patients without hypertension, the risk of having a significant lesion was similar in blacks and whites (adjusted risk ratio 0.97; 95% CI 0.67-1.37). The interaction term for race and hypertension was confirmed as statistically significant. CONCLUSIONS: Among patients electively referred for angiography, hypertension, and its effects may contribute to the lower rate of CAD found in blacks compared to whites. |
| | |
Authors:
|
Matthew A Triplette; Joseph S Rossi; Anthony J Viera; Mauricio G Cohen; Donald E Pathman |
Publication Detail:
|
Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't Date: 2010-11-18 |
Journal Detail:
|
Title: American journal of hypertension Volume: 24 ISSN: 1941-7225 ISO Abbreviation: Am. J. Hypertens. Publication Date: 2011 Feb |
Date Detail:
|
Created Date: 2011-01-20 Completed Date: 2011-05-03 Revised Date: 2011-06-30 |
Medline Journal Info:
|
Nlm Unique ID: 8803676 Medline TA: Am J Hypertens Country: United States |
Other Details:
|
Languages: eng Pagination: 181-6 Citation Subset: IM |
Affiliation:
|
Department of Public Health Leadership, University of North Carolina at Chapel Hill, USA. matthew_triplette@med.unc.edu |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Academic Medical Centers
/
statistics & numerical data African Americans / statistics & numerical data* Blood Pressure* Coronary Angiography / statistics & numerical data* Coronary Stenosis / ethnology*, physiopathology, radiography* European Continental Ancestry Group / statistics & numerical data* Female Health Status Disparities* Humans Hypertension / ethnology*, physiopathology Logistic Models Male Middle Aged Predictive Value of Tests Risk Assessment Risk Factors Severity of Illness Index United States / epidemiology |
| Comments/Corrections | |
Comment In:
|
Am J Hypertens. 2011 Feb;24(2):121
[PMID:
21248729
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Vitamin D and subsequent systolic hypertension among women.
Next Document: Greater coffee intake in men is associated with steeper age-related increases in blood pressure.