title: Influence of Genetic Risk Factors on Coronary Heart Disease Occurrence in Afro-Caribbeans.
abstract: Despite excessive rates of cardiovascular risk factors such as hypertension, diabetes, and obesity, Afro-Caribbeans have lower mortality rates from coronary heart disease (CHD) than do whites. This study evaluated the association of genetic risk markers previously identified in whites and CHD in Afro-Caribbeans.
  
  
  
  We studied 537 Afro-Caribbean individuals (178 CHD cases and 359 controls) who were genotyped for 19 CHD-related single-nucleotide polymorphisms (SNPs). A genetic risk score (GRS) incorporating the 19 SNPs was calculated. These participants were compared with 1360 white individuals from the Second Northwick Park Heart Study.
  
  
  
  In Afro-Caribbeans, patients with CHD had higher rates of hypertension (78.7% vs 30.1%), hypercholesterolemia (52.8% vs 15.0%), and diabetes (53.9% vs 14.8%) and were more often men (64.0% vs 43.7%) and smokers (27.5% vs 13.4%) compared with non-CHD controls (all P < 0.001). The GRS was higher in Afro-Caribbeans with CHD than in those without CHD (13.90 vs 13.17; P < 0.001) and was significantly associated with CHD after adjustment for cardiovascular risk factors, with an odds ratio of 1.40 (95% confidence interval, 1.09-1.80) per standard deviation change. There were significant differences in allelic distributions between the 2 ethnic groups for 14 of the 19 SNPs. The GRS was substantially lower in Afro-Caribbean controls compared with white controls (13.17 vs 16.59; P < 0.001).
  
  
  
  This study demonstrates that a multilocus GRS composed of 19 SNPs associated with CHD in whites is a strong predictor of the disease in Afro-Caribbeans. The differences in CHD occurrence between Afro-Caribbeans and whites might be a result of significant discrepancies in common gene variant distribution.
authors.affiliation: Research Group Clinical Epidemiology and Medicine, ECM/L.A.M.I.A EA 4540, University Hospital of Pointe-à-Pitre, University of Antilles, Guadeloupe, France; Centre for Cardiovascular Genetics, British Heart Foundation Laboratories, Institute of Cardiovascular Sciences, University College London, London, United Kingdom; Department of Cardiology, University Hospital of Pointe-à-Pitre, Guadeloupe, France. Electronic address: l.larifla@ucl.ac.uk.
authors.forename: Laurent
authors.initials: L
authors.lastname: Larifla
authors.affiliation: Centre for Cardiovascular Genetics, British Heart Foundation Laboratories, Institute of Cardiovascular Sciences, University College London, London, United Kingdom.
authors.forename: Katherine E
authors.initials: KE
authors.lastname: Beaney
authors.affiliation: Research Group Clinical Epidemiology and Medicine, ECM/L.A.M.I.A EA 4540, University Hospital of Pointe-à-Pitre, University of Antilles, Guadeloupe, France.
authors.forename: Lydia
authors.initials: L
authors.lastname: Foucan
authors.affiliation: Research Group Clinical Epidemiology and Medicine, ECM/L.A.M.I.A EA 4540, University Hospital of Pointe-à-Pitre, University of Antilles, Guadeloupe, France.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Bangou
authors.affiliation: Department of Cardiology, University Hospital of Pointe-à-Pitre, Guadeloupe, France.
authors.forename: Carl T
authors.initials: CT
authors.lastname: Michel
authors.affiliation: Department of Cardiology, University Hospital of Pointe-à-Pitre, Guadeloupe, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Martino
authors.affiliation: Research Group Clinical Epidemiology and Medicine, ECM/L.A.M.I.A EA 4540, University Hospital of Pointe-à-Pitre, University of Antilles, Guadeloupe, France.
authors.forename: Fritz-Line
authors.initials: FL
authors.lastname: Velayoudom-Cephise
authors.affiliation: Centre for Cardiovascular Genetics, British Heart Foundation Laboratories, Institute of Cardiovascular Sciences, University College London, London, United Kingdom.
authors.forename: Jackie A
authors.initials: JA
authors.lastname: Cooper
authors.affiliation: Centre for Cardiovascular Genetics, British Heart Foundation Laboratories, Institute of Cardiovascular Sciences, University College London, London, United Kingdom.
authors.forename: Steve E
authors.initials: SE
authors.lastname: Humphries
mesh_terms: D044383:Black People / Q000235:genetics*; D016022:Case-Control Studies; D003327:Coronary Disease / Q000208:ethnology* / Q000235:genetics*; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D005787:Gene Frequency; D020022:Genetic Predisposition to Disease; D005838:Genotype; D019430:Guadeloupe / Q000208:ethnology; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D020641:Polymorphism, Single Nucleotide; D018570:Risk Assessment; D012907:Smoking / Q000453:epidemiology; D044465:White People / Q000235:genetics