title: Cardiovascular disease risk amongst African black patients with rheumatoid arthritis: the need for population specific stratification.
abstract: Rheumatoid arthritis (RA) enhances the risk of cardiovascular disease to a similar extent as diabetes. Whereas atherogenesis remains poorly elucidated in RA, traditional and nontraditional risk factors associate similarly and additively with CVD in RA. Current recommendations on CVD risk stratification reportedly have important limitations. Further, reported data on CVD and its risk factors derive mostly from data obtained in the developed world. An earlier epidemiological health transition is intrinsic to persons living in rural areas and those undergoing urbanization. It is therefore conceivable that optimal CVD risk stratification differs amongst patients with RA from developing populations compared to those from developed populations. Herein, we briefly describe current CVD and its risk factor profiles in the African black population at large. Against this background, we review reported data on CVD risk and its potential stratification amongst African black compared to white patients with RA. Routinely assessed traditional and nontraditional CVD risk factors were consistently and independently related to atherosclerosis in African white but not black patients with RA. Circulating concentrations of novel CVD risk biomarkers including interleukin-6 and interleukin-5 adipokines were mostly similarly associated with both endothelial activation and atherosclerosis amongst African black and white RA patients.
authors.affiliation: Department of Rheumatology, Charlotte Maxeke Johannesburg Academic Hospital, Faculty of Health Sciences, University of the Witwatersrand, Parktown 2193, Johannesburg, South Africa.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Solomon
authors.affiliation: Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, P.O. Box 1012, Melville 2109, Johannesburg, South Africa.
authors.forename: Linda
authors.initials: L
authors.lastname: Tsang
authors.affiliation: Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, P.O. Box 1012, Melville 2109, Johannesburg, South Africa.
authors.forename: Angela J
authors.initials: AJ
authors.lastname: Woodiwiss
authors.affiliation: Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, P.O. Box 1012, Melville 2109, Johannesburg, South Africa.
authors.forename: Aletta M E
authors.initials: AM
authors.lastname: Millen
authors.affiliation: Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, P.O. Box 1012, Melville 2109, Johannesburg, South Africa.
authors.forename: Gavin R
authors.initials: GR
authors.lastname: Norton
authors.affiliation: Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, P.O. Box 1012, Melville 2109, Johannesburg, South Africa.
authors.forename: Patrick H
authors.initials: PH
authors.lastname: Dessein
mesh_terms: D054392:Adipokines / Q000097:blood; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000150:complications* / Q000453:epidemiology*; D044383:Black People / Q000706:statistics & numerical data*; D002318:Cardiovascular Diseases / Q000097:blood / Q000150:complications* / Q000453:epidemiology*; D004730:Endothelium, Vascular / Q000473:pathology; D006801:Humans; D012307:Risk Factors
chemical_list: D054392:Adipokines