PREMENOPAUSAL BLACK-WOMEN HAVE MORE RISK-FACTORS FOR CORONARY HEART-DISEASE THAN WHITE WOMEN

Premenopausal black women have a 2- to 3-fold greater rate of coronary heart disease (CHD) than premenopausal white women. The purpose of th is study was to provide greater insight into the reasons for this diff erence, which are currently unclear. We compared CHD risk factors in 9 9 black and 100 white, healthy premenopausal women, aged 18 to 45 year s, and of relatively advantaged socioeconomic status. Compared with wh ite women, black women had a higher body mass index (32.0 +/- 9.2 vs 2 9.0 +/- 9.4 kg/m(2), p = 0.021), and higher systolic (124 +/- 17 vs 11 5 +/- 14 mm Hg, p <0.0001) and diastolic (79 +/- 14 vs 75 +/- 11 mm Hg , p = 0.048) blood pressures. The mean plasma lipoprotein(a) concentra tion was markedly higher in the block women (40.2 +/- 31.3 mg/dl) than in the white women (19.2 +/- 23.7 mg/dl, p <0.0001). The plasma total homocysteine level was also higher in the black women (8.80 +/- 3.38 vs 7.81 +/- 2.58 mu mol/L, p = 0.013). The black women, however, had l ower plasma triglyceride levels (0.91 +/- 0.46 vs 1.22 +/- 0.60 mmol/L , p <0.0001), and a trend toward higher high-density lipoprotein (HDL) cholesterol levels (1.37 +/- 0.34 vs 1.29 +/- 0.31 mmol/L, p = 0.064) than the white women. Plasma total and low-density lipoprotein (LDL) cholesterol levels were similar, despite a greater consumption of satu rated fat and cholesterol by the black women. Rates of cigarette smoki ng and alcohol intake were low and similar between the races. In summa ry, premenopausal black women had a higher mean body mass index, blood pressure lipoprotein(a), and plasma total homocysteine level, and a g reater consumption of saturated Fat and cholesterol than white women. These differences in coronary risk factors may place the black women i n our study at increased risk for CHD compared with the white women. ( C)1998 by Excerpta Medica, Inc.