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Yu YL, An DW, Chori BS, Kaleta BP, Mokwatsi G, Martens DS, Abiodun OO, Anya T, Łebek-Szatańska A, Yeh JS, Mels CM, Latosinska A, Kruger R, Isiguzo G, Narkiewicz K, Shehu MN, Salazar M, Espeche W, Mujaj B, Brgulian-Hitij J, Olszanecka A, Wojciechowska W, Reyskens P, Rajzer M, Januszewicz A, Stolarz-Skrzypek K, Asayama K, Allegaert K, Verhamme P, Mischak H, Nawrot TS, Odili AN, Staessen JA. Racial and regional disparities in the risk of noncommunicable disease between sub-Saharan black and European white patients. J Hypertens 2025; 43:481-491. [PMID: 39655600 PMCID: PMC11789602 DOI: 10.1097/hjh.0000000000003930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2024] [Revised: 10/30/2024] [Accepted: 11/09/2024] [Indexed: 02/01/2025]
Abstract
OBJECTIVES Greater vulnerability of Black vs. White individuals to cardiovascular disease (CVD) and chronic kidney disease (CKD) is well charted in the United States, but studies involving sub-Saharan blacks are scarce. METHODS Baseline data (2021-2024) were collected in 168 sub-Saharan Blacks and 93 European Whites in an ongoing clinical trial (NCT04299529), using standardized patient selection criteria. Data included clinical and biochemical risk factors, ECG and echocardiographic traits, Framingham CVD risk, CKD grades (KDIGO 2024), self-assessed symptoms (WHO questionnaire), and urinary proteomic profiles predictive of left ventricular dysfunction (LVD) and CKD, HF1, and CKD273, respectively. Racial comparisons rested on unadjusted and multivariable-adjusted analyses. RESULTS Despite being younger (60.4 vs. 68.3 years), blacks had a worse risk profile, as evidenced by higher diabetes prevalence, higher BMI, faster heart rate, unfavourable serum cholesterol fractions, lower estimated glomerular filtration rate, microalbuminuria, and sedentary lifestyle. This resulted in blacks having higher 10-year CVD risk, higher heart age (index of vascular ageing with chronological age as reference), and a worse CKD grades. In both races, CKD273 increased with CKD grade, but CKD273 and HF1 were not different by race. These observations were robust in subgroup and adjusted analyses. CONCLUSION This study did not differentiate host (genetic, molecular, and pathogenic) from environmental drivers of disease. Nonetheless, the findings call for a multipronged and comprehensive implementation of innovative health policies in sub-Saharan countries. Education, research, empowerment of stakeholders, and international learned societies connecting experts from a wide array of disciplines should vigorously sustain this effort.
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Affiliation(s)
- Yu-Ling Yu
- Research Unit Environment and Health, KU Leuven Department of Public Health and Primary Care, University of Leuven, Leuven
- Non-Profit Research Association Alliance for the Promotion of Preventive Medicine, Mechelen, Belgium
| | - De-Wei An
- Non-Profit Research Association Alliance for the Promotion of Preventive Medicine, Mechelen, Belgium
- Department of Cardiovascular Medicine, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, State Key Laboratory of Medical Genomics, National Research Centre for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Center for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | - Babangida S. Chori
- Non-Profit Research Association Alliance for the Promotion of Preventive Medicine, Mechelen, Belgium
- Center for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
- Department of Internal Medicine, Faculty of Clinical Sciences, College of Health Sciences, University of Abuja, Abuja, Nigeria
| | - Błażej P. Kaleta
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagellonian University, Kraków, Poland
| | - Gontse Mokwatsi
- Hypertension in Africa Research Team, Medical Research Council Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Dries S. Martens
- Center for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | | | - Tina Anya
- Department of Internal Medicine, Federal Medical Center Jabi, Abuja, Nigeria
| | | | - Jong-Shiuan Yeh
- Taipei Municipal Wang-Fang Hospital
- Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Catharina M.C. Mels
- Hypertension in Africa Research Team, Medical Research Council Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | | | - Ruan Kruger
- Hypertension in Africa Research Team, Medical Research Council Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Godsent Isiguzo
- Department of Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Ebonyi, Nigeria
| | - Krzystof Narkiewicz
- Department of Hypertension and Diabetology, Medical University of Gdańsk, Gdańsk, Poland
| | | | - Martin Salazar
- Universidad Nacional de La Plata | UNLP Departamento de Medicina Interna y Especialidades Clínicas, La Plata, Argentina
| | - Walter Espeche
- Universidad Nacional de La Plata | UNLP Departamento de Medicina Interna y Especialidades Clínicas, La Plata, Argentina
| | - Blerim Mujaj
- Non-Profit Research Association Alliance for the Promotion of Preventive Medicine, Mechelen, Belgium
| | - Jana Brgulian-Hitij
- Department of Internal Medicine, Division of Hypertension, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Agnieszka Olszanecka
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagellonian University, Kraków, Poland
| | - Wiktoria Wojciechowska
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagellonian University, Kraków, Poland
| | | | - Marek Rajzer
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagellonian University, Kraków, Poland
| | - Andrzej Januszewicz
- Department of Hypertension, National Institute of Cardiology, Warsaw, Poland
| | - Katarzyna Stolarz-Skrzypek
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagellonian University, Kraków, Poland
| | - Kei Asayama
- Non-Profit Research Association Alliance for the Promotion of Preventive Medicine, Mechelen, Belgium
- Tohoku Institute for Management of Blood Pressure, Sendai, Japan
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Karel Allegaert
- Department of Pharmaceutical and Pharmacological Sciences
- KU Leuven Department of Development and Regeneration, KU Leuven, Leuven, Belgium
- Department of Hospital Pharmacy, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Peter Verhamme
- Center for Molecular and Vascular Biology, KU Leuven Department of Cardiovascular Sciences
| | | | - Tim S. Nawrot
- Research Unit Environment and Health, KU Leuven Department of Public Health and Primary Care, University of Leuven, Leuven
- Center for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | - Augustine N. Odili
- Department of Internal Medicine, Faculty of Clinical Sciences, College of Health Sciences, University of Abuja, Abuja, Nigeria
| | - Jan A. Staessen
- Non-Profit Research Association Alliance for the Promotion of Preventive Medicine, Mechelen, Belgium
- Department of Cardiovascular Medicine, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, State Key Laboratory of Medical Genomics, National Research Centre for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Biomedical Science Group, Faculty of Medicine, University of Leuven, Leuven, Belgium
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