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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2005;25:2362.)
© 2005 American Heart Association, Inc.

Vascular Biology

Ethnic Differences in Arterial Responses and Inflammatory Markers in Afro-Caribbean and Caucasian Subjects

Lalit Kalra; Curtis Rambaran; Philip Chowienczyk; David Goss; Ian Hambleton; James Ritter; Ajay Shah; Rainford Wilks; Terrence Forrester

From the Cardiovascular Division (L.K., C.R., P.C., D.G., J.R., A.S.), Guy’s, King’s, and St Thomas’s School of Medicine, King’s College, London, UK; and Tropical Medicine Research Institute (I.H., R.W., T.F.), University of West Indies, Mona, Kingston, Jamaica, West Indies.

Correspondence to Lalit Kalra, Department of Medicine, Guy’s, King’s, and St Thomas’s School of Medicine, Denmark Hill Campus, Bessemer Road, London SE5 9PJ, United Kingdom. E-mail lalit.kalra{at}kcl.ac.uk

Objective— Small vessel disease is more common in Afro-Caribbeans than Caucasians. We investigated underlying differences in metabolic, inflammatory, and vascular responses that may predispose Afro-Caribbeans to small vessel pathology.

Methods and Results— Seventy-eight Afro-Caribbeans aged 35–75 years, with no vascular disease or medications, were compared with 82 matched Caucasians for metabolic variables, fasting insulin, interleukin 6, tumor necrosis factor (TNF) , and cytoplasmic repressor protein levels. Carotid intima media thickness (CIMT) was measured ultrasonographically. Small vessel function was assessed by measuring the absolute change from baseline in the reflectance index (RI) of the digital volume pulse during IV infusion of albuterol (5 µg/min, RI_ALB) and glyceryl tri nitrate (5 µg/min, RI_GTN). Large artery elasticity was measured as the stiffness index (SI) and derived from the time to pulse wave reflection adjusted for subject height. Afro-Caribbeans had significantly higher diastolic blood pressure (80.3 versus 77.6 mm Hg; P=0.033), fasting insulin (14.0 versus 10.6 µU/mL; P=0.026), TNF- (6.7 versus 4.3; pg/mL; P=0.001), and interleukin 6 (2.3 versus 1.5 pg/mL; P=0.036) levels compared with Caucasians. CIMT was greater (0.81±0.20 versus 0.75±0.18 mm; P=0.02) and small vessel reactivity attenuated (mean RI_ALB 6.8±8.0% versus 12.3±8.%; P<0.0001) in Afro-Caribbeans, but their large artery elasticity (mean index of large artery stiffness 9.9 versus 9.7 m/s; P=0.48) was comparable with Caucasians. CIMT was independently associated with an index of large artery stiffness (ß=0.03; P=0.002) in Caucasians but not in Afro-Caribbeans. There were independent relationships among Afro-Caribbean ethnicity, TNF-, and insulin levels.

Conclusions— Selective impairment of small artery function may contribute to excess small vessel disease in Afro-Caribbeans.

Small vessel disease is more common in Afro-Caribbeans. A comparison of metabolic variables, inflammatory markers, and arterial function between 78 healthy Afro-Caribbeans and 82 matched Caucasians showed higher diastolic blood pressure, fasting insulin, tumor necrosis factor , and interleukin 6 levels in Afro-Caribbeans, which was associated with the attenuation of small, but not large, vessel function.

Key Words: ethnicity • vascular reactivity • artery stiffness • atherosclerosis

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