High triglyceride to HDL cholesterol ratio is associated with increased coronary heart disease among White but not Black adults

Objective: Black adults are less likely than White adults to present with adverse lipid profiles and more likely to present with low-grade inflammation. The impact of race on the association between atherogenic lipid profiles, inflammation, and coronary heart disease (CHD) is unknown. Methods: We ev...

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Main Authors: Cesar Higgins Tejera (Author), Jessica Minnier (Author), Sergio Fazio (Author), Monika M Safford (Author), Lisandro D. Colantonio (Author), Marguerite R Irvin (Author), Virginia Howard (Author), Neil A Zakai (Author), Nathalie Pamir (Author)
Format: Book
Published: Elsevier, 2021-09-01T00:00:00Z.
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042 |a dc 
100 1 0 |a Cesar Higgins Tejera  |e author 
700 1 0 |a Jessica Minnier  |e author 
700 1 0 |a Sergio Fazio  |e author 
700 1 0 |a Monika M Safford  |e author 
700 1 0 |a Lisandro D. Colantonio  |e author 
700 1 0 |a Marguerite R Irvin  |e author 
700 1 0 |a Virginia Howard  |e author 
700 1 0 |a Neil A Zakai  |e author 
700 1 0 |a Nathalie Pamir  |e author 
245 0 0 |a High triglyceride to HDL cholesterol ratio is associated with increased coronary heart disease among White but not Black adults 
260 |b Elsevier,   |c 2021-09-01T00:00:00Z. 
500 |a 2666-6677 
500 |a 10.1016/j.ajpc.2021.100198 
520 |a Objective: Black adults are less likely than White adults to present with adverse lipid profiles and more likely to present with low-grade inflammation. The impact of race on the association between atherogenic lipid profiles, inflammation, and coronary heart disease (CHD) is unknown. Methods: We evaluated the association between high levels (>50th percentile) of high-sensitivity C-reactive protein (hsCRP) and of triglycerides to high density lipoprotein ratio (TG/HDL-C) and CHD events by race in the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort with 30,239 Black and White participants aged 45 and older. Results: Participants with both high hsCRP and high TG/HDL-C had highest rates of CHD (HR 1.84; 95% CI: 1.48, 2.29 vs HR 1.52; 95% CI: 1.19, 1.94 in White vs Black participants respectively). Whereas isolated high hsCRP was associated with increased CHD risk in both races (HR 1.68; 95% CI: 1.31, 2.15 and HR 1.43; 95% CI: 1.13, 1.81 for White and Black participants respectively), isolated high TG/HDL was associated with increased CHD risk only in White participants (HR 1.44; 95% CI: 1.15, 1.79 vs HR 1.01; 95% CI: 0.74, 1.38). Further, the effects of high hsCRP and high TG/HDL-C were additive, with inflammation being the driving variable for the association in both races. Conclusion: In both races, higher inflammation combined with adverse lipid profile is associated with greater CHD risk. Therefore, inflammation increases CHD risk in both races whereas dyslipidemia alone is associated with a greater risk in White but not in Black adults. hsCRP testing should be a standard feature of CHD risk assessment, particularly in Black patients. 
546 |a EN 
690 |a TG/HDL ratio 
690 |a Dyslipidemia 
690 |a CAD 
690 |a CHD 
690 |a Vascular Inflammation 
690 |a hsCRP 
690 |a Diseases of the circulatory (Cardiovascular) system 
690 |a RC666-701 
690 |a Public aspects of medicine 
690 |a RA1-1270 
655 7 |a article  |2 local 
786 0 |n American Journal of Preventive Cardiology, Vol 7, Iss , Pp 100198- (2021) 
787 0 |n http://www.sciencedirect.com/science/article/pii/S2666667721000520 
787 0 |n https://doaj.org/toc/2666-6677 
856 4 1 |u https://doaj.org/article/e88e4a83231d474a8aa3d9c68d12bab1  |z Connect to this object online.