Publications
The Metabolic Syndrome in African Americans: A Review
W. Dallas Hall, MD; Luther T. Clark, MD; Nanette K. Wenger, MD; Jackson T. Wright Jr, MD, PhD; Shiriki K. Kumanyika, PhD, MPH; Karol Watson, MD, PhD; Ella W. Horton, PharmD; John M. Flack, MD, MPH; Keith C. Ferdinand, MD; James R. Gavin III, MD, PhD; James W. Reed, MD; Elijah Saunders, MD; Welton O'Neal Jr, PharmD
The Metabolic Syndrome represents a specific clustering of cardiovascular risk factors. One of several recently proposed definitions encompasses 3 or more of the following 5 abnormalities: waist circumference >102 cm in men or >88 cm in women, serum triglyceride level >150 mg/dL, high-density lipoprotein cholesterol level <40 mg/dL in men or <50 mg/dL in women, blood pressure (BP) >130/>85 mm Hg, and serum glucose >110 mg/dL. The diagnosis of Metabolic Syndrome allows early recognition of an increased risk of cardiovascular disease.
African Americans have the highest coronary heart disease mortality of any ethnic group in the United States. African-American women and Hispanic men and women have the highest prevalence of the Metabolic Syndrome. This phenomenon is attributable mainly to the disproportionate occurrence of elevated BP, obesity, and diabetes in African Americans, and the high prevalence of obesity and diabetes in Hispanics.
Management of the Metabolic Syndrome consists primarily of modification or reversal of the root causes and direct therapy of the risk factors. The first strategy involves weight reduction and increased physical activity, both of which can improve all components of the syndrome. The second strategy often involves drug treatment of the individual risk factors to further improve BP, lipids, and glucose thereby decreasing the risk of cardiovascular disease.
This comprehensive review is provided as part of the educational activities of the African-American Lipid and Cardiovascular Council (AALCC).
Ethn Dis. 2003;13(2):414-428.
Click here to download the full text article The Metabolic Syndrome in African Americans: A Review.
Coronary Heart Disease in African Americans
Luther T. Clark, MD, Keith C. Ferdinand, MD, John M. Flack, MD, MPH, James R. Gavin, III, MD, PhD, W. Dallas Hall, MD, MACP, Shiriki K. Kumanyika, PhD, MPH, RD, James W. Reed, MD, Elijah Saunders, MD, Hannah A. Valantine, MD, MRCP, Karol Watson, MD, PhD, Nanette K. Wenger, MD, and Jackson T. Wright, MD, PhD
African Americans have the highest overall mortality rate from coronary heart disease (CHD) of any ethnic group in the United States, particularly out-of-hospital deaths, and especially at younger ages. Although all of the reasons for the excess CHD mortality among African Americans have not been elucidated, it is clear that there is a high prevalence of certain coronary risk factors, delay in the recognition and treatment of high-risk individuals, and limited access to cardiovascular care. The clinical spectrum of acute and chronic CHD in African Americans is similar to that in whites. However, African Americans have a higher risk of sudden cardiac death and present more often with unstable angina and non-Q-wave myocardial infarction than whites. African Americans have less obstructive coronary artery disease on angiography, but may have a similar or greater total burden of coronary atherosclerosis. Ethnic differences in the clinical manifestations of CHD may be explained largely by the inherent heterogeneity of the coronary syndromes, and the disproportionately high prevalence and severity of hypertension and type 2 diabetes in African Americans. Identification of high-risk individuals for vigorous risk factor modification—especially control of hypertension, regression of left ventricular hypertrophy, control of diabetes, treatment of dyslipidemia, and smoking cessation—is key for successful risk reduction.
Heart Disease 2001;3(2):97-108.
Click here to download the full text article Coronary Heart Disease in African Americans.
Annotated Bibliography: Lipids in Blacks (1993 - 2001)
African-American Lipid & Cardiovascular Council
The AALCC previously made available a listing of all of the known literature (419 references, 1936-1993) on lipids in blacks. This is available and can be downloaded from the AALCC website at African-American Lipid & Cardiovascular Council web site.
This updated listing (1993-2001) includes selected recent references on lipids in blacks. Abstracts are not included. A few 1991-92 key references appear if they were missed in the 1936-1993 listing. Both documents are an outgrowth of educational activities of the African American Lipid and Cardiovascular Council (AALCC). The members contributing to this bibliography include:
These 260 recent references refer very specifically to available data and correlates of serum lipid levels in blacks. They do not usually include data such as the incidence or prevalence of coronary heart disease, etc if lipid levels are not a part of the article or reference. Articles on lipid levels or treatment recommendations in populations with minimal or no blacks (eg, AFCAPS, 4-S, LIPID, etc) are not included.
The listing is particularly useful in several regards:
We have done our best to assure completeness, accuracy, and precision in the listings. We encourage you to forward any additional key references for the list so that we may all share in the new knowledge on this important topic.
This document requires the Adobe Acrobat Reader for viewing. If you do not have Adobe Acrobat Reader installed on your computer, click here to get it.
This document requires the Adobe Acrobat Reader for viewing. If you do not have Adobe Acrobat Reader installed on your computer, click here to get it.
W. Dallas Hall, MD
Luther T. Clark, MD
Keith C. Ferdinand, MD
John M. Flack, MD, MPH
James R. Gavin, III, MD, PhD
Ella W. Horton, PharmD
Shiriki K. Kumanyika, PhD, MPH, RD
Welton O'Neal, PharmD
James W. Reed, MD
Elijah Saunders, MD
Hannah A. Valantine, MD, MRCP
Karol Watson, MD, PhD
Nanette K. Wenger, MD
Jackson Wright, MD, PhD
Ella Horton, PharmD
* Sponsored by an educational grant from Bristol-Myers Squibb
Click here to download the Annotated Bibliography: Lipids in Blacks (1993 - 2001). The following document requires the Adobe Acrobat Reader for viewing. If you do not have Adobe Acrobat Reader installed on your computer, click here to get it.
Bibliography: Serum Lipids in Blacks (1936 - 1994)
African-American Lipid & Cardiovascular Council
This cumulative listing of 419 references on serum lipoproteins in black and some other minority individuals is an outgrowth of activities of the African American Lipid Council (AALC). The AALC was formed in 1991 as a non-profit health professional advisory group. A major goal of AALC was enhancement of public awareness of the importance of lipid disorders in African Americans. This was stimulated, in part, by the 3 to 70% higher CHD death rate among blacks than among whites of similar age (up to age 75), and the observation that the rate of decline in CHD death rates in the U.S. is less in blacks than in whites.
CHD is the leading cause of death in African Americans. Risk factors are common for CHD and especially prevalent with regard to hypertension, diabetes mellitus, and smoking. The higher LP(a) levels and prevalence of obesity (black women) also could contribute to higher risk. Clustering of hypercholesterolemia and other risk factors is common in African Americans. Special approaches may be needed for effective public and professional education as well as community screening, detection, referral and management of CHD risk factors.
The 419 references are from 94 different journals, many of which are not easily accessed. They refer specifically to available data and correlates of serum lipid levels. They do not usually include data (except in the recommended selected readings) such as the incidence or prevalence of coronary heart disease if serum lipid levels are not a part of the article or reference. Also, articles on lipid levels or treatment recommendations in caucasian-only populations are not included.
The listing is somewhat unique in serval regards:
We have done our best to assure completeness, accuracy and precision in the listings. We encourage you to forward any additional references for the list so that we may all share in the old and new knowledge on this important topic.
W. Dallas Hall, M.D. (Editor) Sponsored in part by an educational grant from Bristol-Myers Squibb
Marlis McDowell Jackson, Secretary
Click here to download the Glossary of Abbreviations used.
Click here to download 15 Selected Books, Reviews, Monographs, and Special Reports
Pages 1 - 5 of the Bibliography.
Pages 6 - 10 of the Bibliography.
Pages 11 - 15 of the Bibliography.
Pages 16 - 20 of the Bibliography.
Pages 21 - 25 of the Bibliography.
Pages 26 - 30 of the Bibliography.
Pages 31 - 35 of the Bibliography.
Pages 36 - 41 of the Bibliography.
Index Medicus Journal (n = 94) Abbreviations.
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