How does ethnicity affect the risk for coronary artery disease (CAD)?

Updated: Mar 30, 2020
  • Author: F Brian Boudi, MD, FACP; Chief Editor: Yasmine S Ali, MD, MSCI, FACC, FACP  more...
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The prospective, observational Reduction of Atherothrombosis for Continued Health (REACH) registry, a large international study of individuals with atherothrombotic disease, documented ethnic-specific differences in cardiovascular risk factors and variations in cardiovascular mortality worldwide. The study found that although prevalence of traditional atherothrombotic risk factors widely varied among the ethnic and racial groups, the use of medical therapies to reduce risk was comparable among all groups. At 2-year follow-up, the rate of cardiovascular death was significantly higher in blacks, and cardiovascular death rates were significantly lower in the Asian groups. [13]

Results from the Atherosclerosis Risk in Communities (ARIC) study suggest that lipoprotein(a) levels are positively associated with cardiovascular disease events, and that these associations were at least as strong, with a larger range of lipoprotein(a) concentrations, in blacks compared with whites. [14]

One meta-analysis by Huxley et al suggests that isolated low high-density lipoprotein cholesterol (HDL-C) is a novel lipid phenotype that appears to be more prevalent among Asian populations; this phenotype also increases the risk of coronary heart disease in the Asian population. [15]  

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