Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “racial differences”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 505 records · Page 28Linked to original sources
PubMed1999

Racial differences in patients' perceptions of debilitated health states.

OBJECTIVE: To determine health utility scores for specific debilitated health states and to identify whether race or other demographic differences predict significant variation in these utility scores. DESIGN: Utility analysis. SETTING: A community hospital general internal medicine clinic, a private internal medicine practice, and a private pulmonary medicine practice. PARTICIPANTS: Sixty-four consecutive patients aged 50 to 75 years awaiting appointments. In order to participate, patients at the pulmonary clinic had to meet prespecified criteria of breathing impairment. MEASUREMENTS: Individuals' strength of preference concerning specific states of limited physical function as measured by the standard gamble technique. MAIN RESULTS: Mean utility scores used to quantitate limitations in physical function were extremely low. Using a scale for which 0 represented death and 1.0 represented normal health, limitation in activities of daily living was rated 0. 19 (95% confidence interval [CI] 0.13, 0.25), tolerance of only bed-to-chair ambulation 0.17 (95% CI 0.11, 0.23), and permanent nursing home placement 0.16 (95% CI 0.10, 0.22). Bivariate analysis identified female gender and African-American race as predictors of higher utility scores ( p </=.05). In multiple regression analysis, only race remained statistically significant ( p </=.02 for all three outcome variables). CONCLUSION: Comparisons of African-American values with those of whites concerning defined states of debility demonstrate greater than threefold increases in utility scores. This finding suggests that racial differences need to be taken into account when studying the effects of medical interventions on quality of life.

Activities of Daily Living↗
PubMed1995

Racial differences in the incidence of femoral bypass and abdominal aortic aneurysmectomy in Massachusetts: relationship to cardiovascular risk factors.

PURPOSE: Atherosclerotic disease appears to be more severe in black patients than in white patients, but abdominal aortic aneurysms, which have traditionally been believed to have an atherosclerotic cause, are reported to be less common in black patients than in white patients. Our goals were to compare and contrast factors associated with the development of abdominal aortic aneurysms and clinically significant atherosclerotic occlusive disease (1) to determine whether these diseases share a common cause and (2) to explore their association with race. METHODS: Dual case-control studies were conducted with multivariate analysis to compare cases (patients undergoing aneurysmectomy or patients undergoing femoral bypass) with a comparison group consisting of patients who had undergone appendectomy. Two data sources were used: (1) hospital discharge data for Massachusetts from 1984 through 1988 and (2) medical records at University Hospital of Boston and Boston City Hospital. For both the Massachusetts database and the hospital chart review, records were obtained for all patients discharged between January 1984 and December 1988 with an International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) procedure code for abdominal aortic aneurysm resection (38.44) or aneurysmorrhaphy (38.34) or with a procedure code for femoral artery bypass/reconstruction (39.29). To conduct a nested case-control study, records were also obtained for a control group consisting of patients between the ages of 50 and 84 years who had undergone appendectomy during the same 5-year period. RESULTS: Black patients had higher rates of femoral bypass than did white patients after adjustment for age and sex (odds ratio = 1.97; 95% confidence interval: 1.49, 2.61; p < 0.0001). However, femoral bypass was also associated with hypertension, diabetes, and low household income. After adjusting for these additional factors in the statewide data set, the black/white odds ratio for femoral bypass was only 1.44 (95% confidence interval: 1.08, 1.92). The parallel case-control study at University Hospital and Boston City Hospital, which provided information about smoking status and more accurate ascertainment of coexisting hypertension and diabetes, indicated that there was no racial difference in rates of femoral bypass after correcting for these additional risk factors (odds ratio = 0.94; 95% confidence interval: 0.40, 2.22; p = 0.90). In contrast, abdominal aortic aneurysmectomy occurred predominantly in white men. Aneurysmectomy was also associated with smoking and hypertension, but aneurysmectomy was not significantly associated with diabetes mellitus or family income. The black/white odds ratio for aneurysm was 0.29; (95% confidence interval: 0.07, 1.23; p = 0.09 after adjustment for other variables). CONCLUSIONS: Hypertension, smoking, and male sex are risk factors for the development of femoral atherosclerosis and abdominal aortic aneurysm formation. However, abdominal aortic aneurysms occur predominantly in white men and do not appear to be associated with diabetes mellitus or income. In contrast, the higher rate of femoral artery bypass in black patients is probably the result of greater prevalence among black patients of hypertension, diabetes, smoking, and perhaps by other ill-defined factors associated with socioeconomic status.

Age Distribution↗
PubMed2005

Racial differences in serum prostate-specific antigen (PSA) doubling time, histopathological variables and long-term PSA recurrence between African-American and white American men undergoing radical prostatectomy for clinically localized prostate cancer.

OBJECTIVE: To determine if there are significant differences in biochemical characteristics, biopsy variables, histopathological data, and rates of prostate-specific antigen (PSA) recurrence between African-American (AA) and white American (WA) men undergoing radical prostatectomy (RP), as AA men are twice as likely to die from prostate cancer than their white counterparts. PATIENTS AND METHODS: We established a cohort of 1058 patients (402 AA, 646 WA) who had RP and were followed for PSA recurrence. Age, race, serum PSA, biopsy Gleason score, clinical stage, pathological stage, and PSA recurrence data were available for the cohort. The chi-square test of proportions and t-tests were used to assess basic associations with race, and log-rank tests and Cox regression models for time to PSA recurrence. Forward stepwise variable selection was used to assess the effect on the risk of PSA recurrence for race, adjusted by the other variables added one at a time. RESULTS: The AA men had higher baseline PSA levels, more high-grade prostatic intraepithelial neoplasia (HGPIN) in the biopsy, and more HGPIN in the pathology specimen than WA men. The AA men also had a shorter mean (sd) PSA doubling time before RP, at 4.2 (4.7) vs 5.2 (5.9) years. However, race was not an independent predictor of PSA recurrence (P = 0.225). Important predictors for PSA recurrence in a multivariable model were biopsy HGPIN (P < 0.014), unilateral vs bilateral cancer (P < 0.006), pathology Gleason score and positive margin status (both P < 0.001). CONCLUSIONS: This study indicates that while there are racial differences in baseline serum PSA and incidence of HGPIN, race is not an independent risk factor for PSA recurrence. Rather, other variables such as pathology Gleason score, bilateral cancers, HGPIN and margin positivity are independently associated with PSA recurrence. The PSA doubling time after recurrence may also be important, leading to the increased mortality of AA men with prostate cancer.

Black or African American↗
PubMed1999

Racial differences in the significance of coronary calcium in asymptomatic black and white subjects with coronary risk factors.

OBJECTIVES: To compare the significance of a specific feature of coronary atherosclerosis--coronary calcium--in asymptomatic black and white subjects with coronary risk factors. BACKGROUND: The natural history and clinical evolution of coronary atherosclerosis differs between blacks and whites. Differences in the underlying pathobiology of atherosclerosis may be one determinant of the ethnic variability in the clinical manifestation of coronary atherosclerosis. METHODS: In 1,375 high-risk but asymptomatic subjects (93 blacks [6.8%] and 1,282 whites [93.2%]) with at least one risk factor but no prior evidence of coronary disease, we assessed coronary risk factors, calculated Framingham risk of a coronary event and evaluated coronary calcium with digital subtraction fluoroscopy. We then followed these subjects clinically for 70 +/- 13 months, noting the occurrence of the following coronary events: death due to coronary heart disease (CHD); myocardial infarction (MI); angina pectoris; and performance of coronary bypass or angioplasty. RESULTS: Risk factor profiles were similar in black and white subjects (6-year Framingham risk 15 +/- 7% in blacks, 14 +/- 8% in whites [NS]). Coronary calcium was present in 59.9% of white subjects but only 35.5% of black subjects (p = 0.0001). Nevertheless, after 70 months of follow-up, more blacks than whites (22 blacks [23.7%] vs. 190 whites [14.8%]; p = 0.04) suffered one of the following end points: CHD death, MI, angina or revascularization. The age, gender and coronary risk-adjusted odds ratio of black race for at least one event was 2.16 (95% CI 1.34 to 3.48). CONCLUSIONS: Despite having a lowered prevalence of coronary calcium than high risk whites, high risk blacks suffer more CHD events. Coronary calcium therefore does not carry the same pathobiologic significance in blacks that it does in whites, consistent with the concept that there are specific racial differences in the natural history of CHD and its evolution into clinically manifest events.

Aged↗
PubMed1997

Racial differences in the renal response to blood pressure lowering during chronic angiotensin-converting enzyme inhibition: a prospective double-blind randomized comparison of fosinopril and lisinopril in older hypertensive patients with chronic renal insufficiency.

This study was undertaken to compare the effects of chronic angiotensin-converting enzyme (ACE) inhibition on blood pressure (BP) and renal hemodynamics in older black and nonblack hypertensive patients with chronic renal insufficiency. A multicenter, placebo lead-in double-blind, parallel group study was performed to compare the antihypertensive efficacy and renal hemodynamic response to the once-daily ACE inhibitor fosinopril (n = 14) and lisinopril (n = 13) over a 22-week period. The study goal was to lower diastolic blood pressure (DBP) to 90 mm Hg or less. Furosemide was added after 6 weeks if blood pressure goal was not achieved. At outpatient clinics at university medical centers, 27 older hypertensive patients (> or = 45 years; 12 blacks, 15 nonblacks; 19 male, eight female) with DBP of 95 mm Hg or higher and 4-hour creatinine clearance 20 to 70 mL/min/1.73 m2 were studied. Changes (delta) from baseline in BP, glomerular filtration rate (GFR), and renal plasma flow (RPF) were measured. Mean systolic blood pressure (SBP) and DBP decreased significantly and to a similar extent in randomized groups: fosinopril (mean +/- SEM) delta DBP at 6 weeks was -13 +/- 2 (P < 0.0001; 95% CI, -16 to -9) and at 22 weeks was -12 +/- 2 (P < 0.0001; 95% CI, -16 to -9); lisinopril delta DBP at 6 weeks was -14 +/- 6 (P < 0.0001; 95% CI, -10 to -18) and at 22 weeks was -16 +/- 2 (P < 0.0001; 95% CI, -12 to -21). GFR and RPF did not change significantly in either group. BP was significantly reduced and to a similar extent in blacks and nonblacks: for blacks, delta DBP at 6 weeks was -11 +/- 3 (P < 0.05; 95% CI, -0.01 to -9) and at 22 weeks was -16 +/- 2 (P < 0.0001; 95% CI, -11 to -20); for nonblacks, delta DBP at 6 weeks was -14 +/- 1 (P < 0.0001; 95% CI, -12 to -17) and at 22 weeks was -12 +/- 2 (P < 0.0001; 95% CI, -16 to -8). Eight patients (five blacks and three nonblacks) required an addition of furosemide after 6 weeks to reach the DBP goal of < or = 90 mm Hg at 22 weeks. GFR was not significantly altered for either racial group at 6 weeks; however, at 22 weeks; however, at 22 weeks, GFR decreased significantly in blacks (delta GFR, -16 +/- 5; P < 0.006; 95% CI, -26 to -5) and tended to increase in nonblacks (delta GFR, 7 +/- 6; P > 0.25). delta GFR correlated directly with the delta RPF (delta GFR = 0.0611* delta RPF -2.35 +; r = 0.68; P < 0.003). There was no correlation between delta MAP and delta GFR or delta RPF in blacks or nonblacks. We conclude that chronic ACE inhibition with fosinopril and lisinopril alone or in combination with furosemide lowers BP in older blacks and nonblacks with hypertension and chronic renal insufficiency. Racial differences in the renal hemodynamic response to chronic ACE inhibition were noted and appear to be independent of diuretic use and the magnitude of BP lowering.

Aged↗
PubMed1997

Racial differences in prostate-specific antigen levels in patients with local-regional prostate cancer.

BACKGROUND: Prostate-specific antigen (PSA) is a good objective measure of tumor cell burden or virulence of disease, or both, in prostate cancer. Many differences between whites and African Americans (AA) have been noted in prostate cancer in the United States, including a poorer outcome in African Americans. To study whether AAs present with more tumor cell burden or more virulent disease, or both, at presentation, serum PSA levels between whites and African Americans are compared. METHODS: Ninety-two patients were seen during April 1988-August 1993 at Albert Einstein Medical Center, Philadelphia; these patients were identified from computer registration records in 1994. Fifty-five patients were AAs and 37 were whites: 14, 55, 15, and 8 had stage A, B, C, or D1 disease, respectively, and 29, 45, and 17 had grade 1, 2, or 3 tumors. Because of positive skewing of actual PSA values, logarithmic transformation was used in statistical analysis. Two sample t-tests and analysis of variance (ANOVA) were used as appropriate. RESULTS: In univariate analysis, stage (P = 0.043), grade (P = 0.003), and race (P = 0.029) were correlated with the PSA levels; higher-stage and -grade patients and those of African American ethnicity had higher mean PSA levels; type of biopsy and age did not influence PSA levels. On multivariate analysis, race retained its statistical significance (P = 0.05), whereas other factors lost their significance. White patients had 0.51 times lower PSA levels than those of African Americans with comparable stage and grade tumors. Using ANOVA, an average white patient with stage B, grade 1 tumor is likely to have a PSA value of 7.92 ng/ml, compared to 13.9 ng/ml in an African American of similar stage and grade tumor. CONCLUSIONS: The findings of the study confirm previously reported, similar findings in the greater Chicago area. The causes of such racial differences are unknown and require study with individual-level socioeconomic status adjustments, although preliminary studies suggest sociological causes. An ongoing Radiation Therapy Oncology Group (RTOG) study will determine whether such differences exist at the national level and will adjust for individual levels of socioeconomic status.

Aged↗
PubMed1998

Racial differences in renal kallikrein excretion: effect of the ovulatory cycle.

BACKGROUND: Renal kallikrein excretion is diminished in essential hypertension, especially in African-Americans, and evidence exists for a major gene effect on the kallikrein phenotype. In addition, urinary kallikrein excretion differs by gender, with ovulating females having greater kallikrein excretion than males or postmenopausal females. Recent studies have shown that renal kallikrein excretion varies in females during the ovulatory cycle, with levels rising during the luteal phase and returning during the follicular phase to levels that are similar to those of males. In family studies, gender differences in urinary kallikrein excretion were present in white subjects, but not black subjects. We therefore hypothesized dysregulation of kallikrein biosynthetic responses in African-Americans. METHODS: We determined urinary kallikrein activity [chromogenic substrate S2266 (D-val-leu-arg-paranitroanilide) assay; in microU/mg creatinine] in white (N = 15) and black (N = 11) ovulating females during the ovulatory cycle. Serum progesterone, estrogen, plasma renin activity as well as urinary aldosterone, and urinary electrolytes were determined to investigate changes between mid-follicular and mid-luteal phases in the two groups. RESULTS: White and black groups were matched for age, body mass index, blood pressure, heart rate and renal function. Ovulatory cycle phases were confirmed by serum progesterone determinations, which increased significantly in whites and blacks to a comparable degree [0.84 +/- 0.14 nmol/liter (mid-follicular) to 29.77 +/- 4.70 nmol/liter (mid-luteal) in whites, 0.67 +/- 0.08 nmol/liter (mid-follicular) to 28.62 +/- 5.83 nmol/liter (mid-luteal) in blacks; P < 0.001 for cycle effect, P = NS for race effect and race X cycle interaction]. Urinary kallikrein activity increased from 623 +/- 86 microU/mg creatinine (mid-follicular) to 948 +/- 142 microU/mg creatinine (mid-luteal) in whites, but did not change in blacks during the ovulatory cycle [239 +/- 73 microU/mg creatinine (mid-follicular] to 244 +/- 41 microU/mg creatinine (mid-luteal)]. Two-way ANOVA revealed significant effects on urinary kallikrein for race (P < 0.001), cycle (P < 0.05), and race X cycle interaction (P < 0.05). Thus, white females had higher urinary kallikrein than black females, and demonstrated a significant increase in urinary kallikrein excretion during the ovulatory cycle, whereas no significant change in urinary kallikrein activity was seen in the black group. Enzyme kinetic studies and mixing studies demonstrated that these racial differences in renal kallikrein excretion were quantitative, rather than due to qualitative differences in the renal kallikrein enzyme or due to the presence of a kallikrein inhibitor. CONCLUSIONS: These results suggest pronounced blunting of menstrual cycle changes in urinary kallikrein excretion in black females. Blunted urinary kallikrein responses during the ovulatory cycle are consistent with dysregulation of renal kallikrein biosynthetic responses in African-Americans, a group at increased risk for hypertension.

Adult↗
PubMed2004

Gender and racial differences in lipoprotein subclass distributions: the STRRIDE study.

Recent research has focused on the potential atherogenicity of various lipoprotein subclasses and their link to coronary heart disease (CHD) risk. This investigation seeks to identify differences in lipoprotein subclass distributions among a biracial, middle-aged population, while controlling for a number of confounding risk factors. Fasting plasma samples were analyzed in 285 sedentary, mildly dyslipidemic, overweight individuals between 40 and 65 years with no known history of CHD or diabetes. Women had lower levels of small and medium LDL, medium VLDL, large VLDL, and small HDL with a much higher concentration of large HDL than men. Whites had significantly more IDL, small LDL, medium VLDL, and large VLDL with lower levels of large LDL than blacks. HDL and LDL size were larger among blacks and women; VLDL size was greater among whites and men. There was also a trend for men to have more LDL particles than women and whites to have a higher LDL particle concentration than blacks. Within this homogenous population, there were distinct differences between gender and racial groups. Blacks and women had less atherogenic profiles than whites and men, which was not evident from the standard lipid panel.

Adult↗
PubMed1999

Racial differences in prostate-specific antigen levels and prostate-specific antigen densities in patients with prostate cancer.

To compare serum prostate-specific antigen (PSA) levels and PSA density (PSAD) among African American (AA), white, and Hispanic men with prostate cancer (PC) seen in an urban, equal-access urology clinic. Between January 1988 and January 1993, 1,105 men were screened for PC at Cook County Hospital in Chicago, Illinois. A total of 529 men underwent transrectal ultrasound-guided prostate gland biopsies for abnormal digital rectal examination, suspect transrectal ultrasound, elevated PSA, or any combination of these abnormalities. PC was found in 246 patients (204 AAs, 22 whites, and 20 Hispanics). We analyzed the differences in PSA and PSAD among the three racial groups using univariate and multivariate analyses adjusting for race, age, clinical stage, and grade. AAs have a higher mean serum PSA levels (21.56 ng/ml) than whites (mean PSA of 10.96 ng/ml) and Hispanics (mean PSA of 8.25 ng/ml) (p = 0.04). The mean PSAD also was higher in AAs than in the other two groups (0.68 versus 0.34 for whites and 0.31 for Hispanics, p = 0.05). On a multivariate analysis, the PC stage and grade were overwhelmingly significant, whereas the race and age lost their statistical significance. AAs have higher serum PSA and PSAD than whites or Hispanics in an equal-access healthcare environment. Race is a significant factor in determining PSA and PSAD on univariate but not on multivariate analysis. Preliminary studies suggest that these differences are due to sociological, not biologic causes. These findings warrant a large, prospective study to investigate the extent and the causes of the racial differences in PSA and PSAD.

Black or African American↗
PubMed1977

Racial differences in nitrogen content of nails among adolescents.

Ectodermal derivatives provide a readily accessible means of chemically evaluating body protein composition. Therefore, it has been postulated that the analysis of nail nitrogen content may reflect recent nutritional status. Assessment of nail nitrogen content has been previously reported in a small group of neonates and school children. The present study was undertaken to determine if standards for nail nitrogen content could be established for adolescents which could then be used in the assessment of protein nutritional status. Nail clippings were obtained from 118 economically indigent urban black youth, 10 black and 39 white subjects from wealthy suburban communities in the New York area, and 10 poor white-Indian adolescents residing within a barrio in Lima, Peru. Nail samples were analyzed for protein content using the micro Kjeldahl technique. Mean nail nitrogen content for wealthy suburban and impoverished urban black youth was 136 and 137 mg N/g of nail, respectively. Values for poor Peruvian white-Indian and affluent suburban white adolescents were 142 and 141 mg N/g of nail, respectively. The differences between ethnic groups were significant using t test analysis at a P value of less than 0.001. No differences, however, were found between either wealthy and poor of the same racial background or when the data were analyzed by gender. These results suggest that differences in nail nitrogen content are at least in part a reflection of ethnicity. These racial differences must be considered in assessing nutritional status by nail nitrogen analysis.

Adolescent↗
PubMed1997

Considerations for racial differences in the athlete's heart and related cardiovascular disease.

Athletic training is often associated with modest increases in left ventricular chamber size, wall thickness, and mass, which appear to be related to the level and intensity of training as well as the type of activity performed. It appears that for given levels and types of training, some individuals show more marked morphologic changes. It has been speculated that the cardiac alterations that occur with athletic conditioning may be due, in part, to genetic factors that exist independent of training. Related to this issue is the possibility that racial (or biologic) differences in cardiac response to exercise may also exist. This article reviews the available data that address racial differences in the cardiac response to exercise and to left ventricular pressure overload and the implications of these findings.

Adaptation, Physiological↗
PubMed1998

Racial differences in the prevalence of monoclonal gammopathy in a community-based sample of the elderly.

PURPOSE: To determine if there is an increased prevalence of monoclonal gammopathy in elderly blacks compared with whites, analogous to the difference in incidence of multiple myeloma reported for the two racial groups and to confirm age and gender relationships. PATIENTS AND METHODS: Subjects were from the Duke Established Populations for the Epidemiologic Study of the Elderly, selected on the basis of stratified random household sampling. Blacks were oversampled to allow for increased statistical precision in racial comparisons. In all, 1,732 subjects (aged > 70 years) consented to blood drawing and constitute the sample for this study. Monoclonal immunoglobulins were determined by agarose gel electrophoresis and immunofixation. RESULTS: One hundred six subjects (6.1%) had a monoclonal gammopathy. There was a greater than twofold difference in prevalence between blacks (8.4%) and whites (3.8%) (P < 0.001); monoclonal gammopathy prevalence increased with age, and was greater in men than women. Those with monoclonal gammopathy did not differ from those without in socioeconomic status, urban/rural residence, or education. The presence of monoclonal gammopathy was not associated with any specific diseases nor with impaired functional status. There was a slight increase in serum creatinine levels and decrease in hemoglobin and albumin levels in patients with monoclonal gammopathy, but no difference in interleukin-6 (IL-6) levels. Moreover, IL-6 levels were not correlated significantly with the level of monoclonal protein. CONCLUSION: Prevalence of monoclonal gammopathy is significantly greater among blacks than whites in a community-based sample, in approximately the same ratio that multiple myeloma has been reported in the two groups. Given the absence of correlation with environmental factors, there may be a biological racial difference in susceptibility to an early event in the carcinogenic process leading to multiple myeloma.

Age Distribution↗
PubMed2005

Racial differences in surgical evaluation, treatment, and outcome of locoregional esophageal cancer: a population-based analysis of elderly patients.

PURPOSE: We investigated racial disparities in access to surgical evaluation, receipt of surgery, and survival among elderly patients with locoregional esophageal cancer. METHODS: We selected 2,946 white patients and 367 black patients who were older than 65 years and had clinically locoregional esophageal cancer in the Surveillance, Epidemiology, and End Results (SEER) registry (1991 to 1999). Treatment and outcome data were obtained from the linked SEER-Medicare databases. We used logistic regression analysis to estimate odds ratios (ORs) for being seen by a surgeon and for undergoing surgery. Cox proportional hazards analyses were performed to estimate hazard ratios (HRs) for survival adjusted for medical, nonmedical, and treatment characteristics. RESULTS: The rate of surgery for black patients was half that of white patients (25% v 46%; OR, 0.38; P < .001), which was caused by both a lower rate of seeing a surgeon (70% v 78%; OR, 0.66; P < .001) and a lower rate of surgery once seen (35% v 59%; OR, 0.38; P < .001). These racial disparities were only partly explained by differences in patient and cancer characteristics, and not by nonmedical factors, such as socioeconomic status. The 2-year survival rate was lower for black patients (18% v 25%; HR, 1.18; P = .004), but this racial difference disappeared when corrected for treatment received (adjusted HR, 1.02; P = .80). CONCLUSION: Underuse of potentially curative surgery is an important potential explanation for the poorer survival of black patients with locoregional esophageal cancer. Barriers to surgical evaluation and treatment need to be reduced, whether related to patient or healthcare system factors.

Age Factors↗
PubMed1996

Racial differences in plasma endothelin-1 concentrations in individuals with essential hypertension.

Hypertension is more prevalent in blacks than whites, and the reasons for this difference remain unclear. To test whether endothelin may play a role in these racial variations, we analyzed plasma samples from black and white women and men with high blood pressure by an enzyme-linked immunoassay specific for endothelin-1 (ET-1), a potent vasoconstrictor, and compared them with those obtained from similar subjects with normal blood pressure. Both female and male hypertensive blacks had elevated levels of immunoreactive ET-1 (11.3 +/- 1.0 and 12.3 +/- 1.3 pmol/L, respectively) compared with values in normotensive control blacks (1.5 +/- 0.2 and 1.4 +/- 0.2 pmol/L). Corresponding values in female and male hypertensive whites were 3.8 +/- 0.6 and 3.8 +/- 0.6 pmol/L, respectively, compared with respective values of 1.4 +/- 0.1 and 2.8 +/- 0.4 pmol/L in normotensive control whites. These results indicate that plasma concentrations of immunoreactive ET-1 levels differ significantly between black and white individuals with high blood pressure. This finding may be an important factor in the etiology of racial differences in the prevalence and severity of hypertension and deserves further study [corrected].

Adult↗
PubMed2002

How to study the prevalence and mechanisms of racial differences in coronary vasomotor response.

The rapid progress of therapeutic modalities of cardiovascular diseases have led to the development of clinical practice guidelines on the basis of large scale clinical trials. However, an individual response of each patient may not match the mean effect of an intervention in these trials. Therefore, recommendations based on clinical trials performed in a given patient population may not be applicable to the other races. Here, we assessed epidemiological and pathophysiological differences in cardiovascular diseases across racial groups. The incidence of coronary artery disease is the lowest in Japan of all the industrialized nations. Our previous study that compared post-hospital course of acute myocardial infarction in Japanese and Caucasians in North America demonstrated that cardiac events were significantly less in Japanese even when the initial infarct size was similar. Ischemic heart disease constitutes the most common cause of heart failure in the United States but nonischemic cardiomyopathy occurs more frequently in Japan. On the other hand, vasospastic angina is by far more common in the Japanese population. The first comparative study we carried out in Japanese and Italian patients with acute myocardial infarction also showed that percentage of vasospasm in the infarct-related arteries is 3 times higher in Japanese. Thus, coronary spasm appears to be more important as well as the pathogenesis of myocardial infarction in Japan. This fact was reflected by the more frequent use of calcium antagonists in Japan during the acute phase of myocardial infarction. On the other hand, the use of inotropic agents has now been contraindicated for the treatment of patients with chronic heart failure, however it may not be the case in the Japanese population in whom mortality is relatively low. Cardiotonic therapy could be justified in Japanese as it allows optimal care in the context of relief of symptoms and an improved quality of life. Therefore, each racial group should obtain specific evidence aimed at developing its own guidelines for therapy rather than translating major guidelines developed for other populations.

Angina Pectoris, Variant↗
PubMed1979

Racial differences in lung function: search for proportional relationships.

A comparison of lung function in Caucasian and East Indian woodworkers revealed marked differences in FEV, FVC, AND MMF in relation to predicted age- and height-specific values of these variables reported in the literature. These findings were not attributable to differences in smoking habits, frequency of respiratory disease, or employment characteristics. Rather, they suggested that the standard values employed were inappropriate for East Indians. An attempt was made to confirm previously reported suggestions of consistent proportional differences in lung function between racial groups which would permit the calculation of a single correction factor. Evidence of a consistent proportional relationship was found for FEV over a wide range of heights and for FVC over a limited range of heights. However, no such relationship was found for MMF.

Adolescent↗
PubMed1991

Dimensions and resistances of the human nose: racial differences.

Dimensions of the external nose and nostrils and nasal airflow resistances were determined in healthy, young Caucasian, Oriental, and Negro adults. Statistically significant variation between racial groups was found in nasal width and the differential between dorsi-ventral and transverse nostril diameters. Corresponding differences were found also in nasal airflow resistances of combined and separate nasal cavities in both the untreated and decongested state. Caucasian noses were leptorrhine, Negro noses were platyrrhine, and Oriental noses were of intermediate dimension. Mean nasal resistances of untreated noses were 0.129 Pa/cm3/sec in Negroes (N = 17), 0.146 in Orientals (N = 20), and 0.184 in Caucasians (N = 24), and differences were more marked when noses were decongested (P less than 0.05 in all cases). Ratios between resistances of untreated and decongested noses showed no statistical differences between racial groups, suggesting a similarity in the mucovascular component of resistances.

Adolescent↗
PubMed1994

Racial differences in the seroprevalence of hepatitis A virus infection in Natal/KwaZulu, South Africa.

The age- and race-specific seroprevalence of hepatitis A virus (HAV) infection was determined by radioimmunoassay (RIA) in 786 subjects between the ages of 6 months to 60 years. More than 50% of African children were seropositive by the age of 5 years. In blood donors (17-60 years), 50% (93/187) of Whites, 67% (110/163) of Indians, 85% (117/137) of Coloureds, and 91% (115/127) of Africans were seropositive. There was a significant difference in the seroprevalence of HAV infection between White blood donors and blood donors from the other three racial groups [Coloureds (P < 0.0001), Africans (P < 0.0001), and Indians (P < 0.001)] and between Indians and Coloureds (P < 0.0001) and Indians and Africans (P < 0.0001). There was no significance difference in HAV infection between Coloureds and Africans (P < 0.200). Eighty-seven per cent (32/37) of rural Africans had previous infection. In the African population HAV infection is acquired in childhood. There are significant racial differences in the seroprevalence of HAV infection. The surveillance of HAV infection may be used as a valuable yardstick to monitor the changing standards of hygiene and socioeconomic conditions of a community in transition in South Africa and to make rational public health decisions regarding a hepatitis A vaccination policy.

Adolescent↗