Ancestry, Telomere Length, and Atherosclerosis Risk

African Americans (AAs) and European Americans (EuAms) display differences in cardiovascular risk factors and mortality from cardiovascular disease (CVD). AAs show a higher prevalence than EuAms in most cardiovascular risk factors.1 These include high blood pressure,1–3 left ventricular hypertrophy,1 obesity,1 and type 2 diabetes mellitus.1,4 National US epidemiologic data indicate that dyslipidemia is less prevalent in AAs than in EuAms.1 However, based on the MESA (Multi-Ethnic Study of Atherosclerosis), AAs and EuAms have a similar prevalence of dyslipidemia, which is less controlled in AAs.5 Other studies also found lower rates of cholesterol testing, dyslipidemia awareness, treatment, and therapeutic goal attainments among AAs than in EuAms.6,7 In some of these studies, ethnic disparities were attenuated by adjustment for social factors and healthcare access,5 whereas in other studies, they were not.7 Notably, compared with EuAms and Mexican-Americans, AAs displayed a higher risk of having 1 or 2 of the 3 major cardiovascular risk factors, that is, diabetes mellitus, dyslipidemia, and hypertension; compared with EuAms, AAs were also more likely to have all the 3 conditions.8 Although these ethnic differences might account for the higher CVD mortality in AAs than EuAms,9,10 the ethnic differences cannot explain consistent observations of less atherosclerosis in the form of plaques, arterial calcifications, and occluded coronary arteries in AAs than in EuAms (Table).1,11–13 This applies to individuals without or with similar cardiovascular risk factors.12–18 View this table: Table. Prevalence of Cardiovascular Risk Factors and Coronary Atherosclerosis in African Americans and European Americans Here, we propose that longer telomeres in AAs than in EuAms19–21 may attenuate the atherosclerotic risk in AAs and explain in part the mortality crossover between elderly AAs …

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