title: High-risk African Americans with multiple risk factors for cardiovascular disease: challenges in prevention, diagnosis, and treatment.
abstract: Coronary heart disease (CHD) is the second leading cause of death in the United States. Despite previous downward trends, which have not persisted, CHD mortality remains higher in African Americans than in Whites. Among African American and White adolescents and adults are trends of increased physical inactivity, smoking, and obesity. Approximately 47 million Americans have metabolic syndrome, a constellation of obesity, hypertension, dyslipidemia, and insulin resistance leading to diabetes. Despite a lower prevalence of metabolic syndrome, African Americans are more insulin resistant than Whites at similar degrees of adiposity, have higher blood pressures, and among women, have more obesity. Since African Americans tend to be diagnosed later and have more risk factors, which confers greater than additive risks, we propose the term "African American multiple-risk patient (AAMRP)." The AAMRP poses clinical and public health challenges for healthcare providers. We provide clinical and public health strategies for early detection and aggressive management of AAMRP.
authors.affiliation: Department of Medicine, The David Geffen School of Medicine at UCLA, Minority Health Institute, Los Angeles, California, USA.
authors.forename: Richard Allen
authors.initials: RA
authors.lastname: Williams
authors.forename: James R
authors.initials: JR
authors.lastname: Gavin
authors.forename: Robert A
authors.initials: RA
authors.lastname: Phillips
authors.forename: Anne E
authors.initials: AE
authors.lastname: Sumner
authors.forename: Alan K
authors.initials: AK
authors.lastname: Duncan
authors.forename: Danielle
authors.initials: D
authors.lastname: Hollar
authors.forename: Charles H
authors.initials: CH
authors.lastname: Hennekens
mesh_terms: D001741:Black or African American; D002318:Cardiovascular Diseases / Q000208:ethnology* / Q000517:prevention & control*; D006801:Humans; D008019:Life Style; D008403:Mass Screening; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D014481:United States