title: African-American ethnicity is associated with higher plasma levels of D-dimer in adults with hypertension.
abstract: BACKGROUND
  African Americans with hypertension have higher cardiovascular morbidity and mortality than hypertensives from other ethnic groups. Plasma D-dimer, a fragment generated from fibrin during lysis of mature clot in vivo, is a predictor of adverse cardiovascular events.
  
  
  OBJECTIVE
  We investigated whether plasma levels of D-dimer differ between African American (AA) and non-Hispanic white (NHW) adults with hypertension.
  
  
  METHODS
  Participants included 933 AA (65 +/- 9 years, 72% women) and 821 NHW (61 +/- 9 years, 56% women) from the community. D-dimer was measured using an immunoturbidimetric assay. Multivariable regression analyses, stratified by gender, were performed to assess whether AA ethnicity was associated with D-dimer levels after adjustment for age, body mass index (BMI), total and high-density lipoprotein (HDL) cholesterol, systolic blood pressure, diabetes, history of smoking, medication (statin and aspirin) use, lifestyle variables (physical activity, alcohol intake, and education), estimated glomerular filtration rate (eGFR), and a marker of inflammation, C-reactive protein (CRP).
  
  
  RESULTS
  D-dimer levels were higher in AA men and women than in their NHW counterparts (mean +/- SD; men 256 +/- 199 vs. 190 +/- 183 ng mL(-1), P < 0.001; women, 290 +/- 233 vs. 225 +/- 195 ng mL(-1), P < 0.001). In both sexes, after adjustment for age, conventional risk factors, medication use, and lifestyle variables, AA ethnicity remained associated with higher D-dimer levels (P = 0.002 in men, P = 0.006 in women). These associations remained significant after additional adjustment for eGFR and plasma CRP (P = 0.003 in men, P < 0.0001 in women).
  
  
  CONCLUSIONS
  Among adults with hypertension, AA ethnicity was independently associated with higher plasma levels of D-dimer.
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: M
authors.initials: M
authors.lastname: Khaleghi
authors.forename: U
authors.initials: U
authors.lastname: Saleem
authors.forename: R D
authors.initials: RD
authors.lastname: McBane
authors.forename: T H
authors.initials: TH
authors.lastname: Mosley
authors.forename: I J
authors.initials: IJ
authors.lastname: Kullo
mesh_terms: D001741:Black or African American; D000368:Aged; D015415:Biomarkers / Q000097:blood; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000208:ethnology*; D008297:Male; D008875:Middle Aged; D009391:Nephelometry and Turbidimetry; D012044:Regression Analysis; D044465:White People
chemical_list: D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D