Health Disparities
Chronic Inflammation Management and Cardiovascular Disease Risk among Black Americans Olivia Affuso* Olivia Affuso Hoda Ahmed Kaylee Zettler Rodney Washington Harish Chander Xiaoqian Zhu
Background: Understanding the interplay of chronic inflammation and elevated cholesterol may be vitally important for screening in Black populations given the increased prevalence of elevated lipoprotein a, which has been characterized as proinflammatory. We hypothesize that measurement of chronic inflammatory may improve CVD risk stratification in this population.
Methods: We utilized data from the National Health and Nutrition Examination Survey (NHANES) 2017-2020 of Black Americans (aged 42.6±18.8 yrs, 45% male) with complete data (N=599). Elevated C-reactive protein (hsCRP) and low-density lipoprotein (LDL) were categorized using cutoffs of >3 mg/L and >100 mg/dL, respectively. Using generalized linear regression with a gamma distribution and log link, we examined the association between hsCRP-LDL groupings and 10-year total CVD Risk score estimated with the Predicting Risk of Incident CVD EVENTs (PREVENT) equation.
Results: The overall prevalence of elevated hsCRP and LDL was 39.8% and 49.1%, respectively. The mean PREVENT risk score was 4.1%[IQR:1.3-10]. Using low CRP/low LDL as the reference group, those in the high hsCRP/low LDL or high hsCRP/ high LDL had an increase in PREVENT risk score, with rate ratio (RR) of 1.354 (95% CI: 1.045,1.755) and 1.393 (95% CI:1.142, 1.700), respectively, after adjusting for age and sex. However, no statistically significant difference in PREVENT risk score was observed for individuals with low hsCRP/high LDL compared to those with low hsCRP/low LDL (RR: 1.114, 95% CI 0.881, 1.410).
Conclusion: These findings suggest that screening for chronic inflammation in addition to LDL cholesterol may be beneficial in identifying and better managing CVD risk via anti-inflammatory strategies such as improving diet quality in Black American populations.