Microvascular vasoregulatory dysfunction in African Americans - An enhanced opportunity for early prevention and treatment of atherosclerotic cardiovascular disease
Atherosclerotic cardiovascular disease and its risk factors and precursors are a major driver of disparities in cardiovascular health. This review examines reported evidence that vascular endothelial dysfunction, and its manifestation as coronary microvascular dysfunction, underlies observed excess...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2024-04-01
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| Series: | American Heart Journal Plus |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666602224000259 |
| _version_ | 1797237923021586432 |
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| author | Renee P. Bullock-Palmer Panithaya Chareonthaitawee Ervin Fox Garth M. Beache |
| author_facet | Renee P. Bullock-Palmer Panithaya Chareonthaitawee Ervin Fox Garth M. Beache |
| author_sort | Renee P. Bullock-Palmer |
| collection | DOAJ |
| description | Atherosclerotic cardiovascular disease and its risk factors and precursors are a major driver of disparities in cardiovascular health. This review examines reported evidence that vascular endothelial dysfunction, and its manifestation as coronary microvascular dysfunction, underlies observed excess morbidity and mortality in African Americans. Advanced imaging insights that reveal patho-mechanisms, along with population evidence from the Jackson Heart Study, and the growing evidence emanating from national and international clinical trials and registries are presented. We examine a physiological framework that recognizes insulin-resistant cardiometabolic underpinnings of the conditions of the American Heart Associations' Life's Essential Eight construct of cardiovascular health as a unifying basis that affords early prevention. Mechanistic-based therapeutic approaches, can subsequently be implemented to interrupt progression to adverse outcomes employing layered, or personalized, treatment strategies of a well-defined set of conditions or diseases. Remaining knowledge gaps are acknowledged. |
| first_indexed | 2024-04-24T17:27:27Z |
| format | Article |
| id | doaj.art-df5f2ac63f1f481fbf404a9ec9b96ba0 |
| institution | Directory Open Access Journal |
| issn | 2666-6022 |
| language | English |
| last_indexed | 2024-04-24T17:27:27Z |
| publishDate | 2024-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Heart Journal Plus |
| spelling | doaj.art-df5f2ac63f1f481fbf404a9ec9b96ba02024-03-28T06:38:59ZengElsevierAmerican Heart Journal Plus2666-60222024-04-0140100382Microvascular vasoregulatory dysfunction in African Americans - An enhanced opportunity for early prevention and treatment of atherosclerotic cardiovascular diseaseRenee P. Bullock-Palmer0Panithaya Chareonthaitawee1Ervin Fox2Garth M. Beache3Department of Cardiology, Deborah Heart and Lung Center, Browns Mills NJ, Department of Medicine, Division of Cardiology, Thomas Jefferson University, Philadelphia, PA, United States of America; Corresponding author.Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States of AmericaDivision of Cardiology, Department of Medicine, University of Mississippi Medical Center, Jackson, MS, United States of AmericaDepartment of Radiology, University of Louisville School of Medicine, Louisville, KY, United States of AmericaAtherosclerotic cardiovascular disease and its risk factors and precursors are a major driver of disparities in cardiovascular health. This review examines reported evidence that vascular endothelial dysfunction, and its manifestation as coronary microvascular dysfunction, underlies observed excess morbidity and mortality in African Americans. Advanced imaging insights that reveal patho-mechanisms, along with population evidence from the Jackson Heart Study, and the growing evidence emanating from national and international clinical trials and registries are presented. We examine a physiological framework that recognizes insulin-resistant cardiometabolic underpinnings of the conditions of the American Heart Associations' Life's Essential Eight construct of cardiovascular health as a unifying basis that affords early prevention. Mechanistic-based therapeutic approaches, can subsequently be implemented to interrupt progression to adverse outcomes employing layered, or personalized, treatment strategies of a well-defined set of conditions or diseases. Remaining knowledge gaps are acknowledged.http://www.sciencedirect.com/science/article/pii/S2666602224000259Coronary artery diseaseMicrovascular anginaCoronary microvascular dysfunctionEndothelial functionCardiometabolic syndromeAHA life's essential 8 |
| spellingShingle | Renee P. Bullock-Palmer Panithaya Chareonthaitawee Ervin Fox Garth M. Beache Microvascular vasoregulatory dysfunction in African Americans - An enhanced opportunity for early prevention and treatment of atherosclerotic cardiovascular disease American Heart Journal Plus Coronary artery disease Microvascular angina Coronary microvascular dysfunction Endothelial function Cardiometabolic syndrome AHA life's essential 8 |
| title | Microvascular vasoregulatory dysfunction in African Americans - An enhanced opportunity for early prevention and treatment of atherosclerotic cardiovascular disease |
| title_full | Microvascular vasoregulatory dysfunction in African Americans - An enhanced opportunity for early prevention and treatment of atherosclerotic cardiovascular disease |
| title_fullStr | Microvascular vasoregulatory dysfunction in African Americans - An enhanced opportunity for early prevention and treatment of atherosclerotic cardiovascular disease |
| title_full_unstemmed | Microvascular vasoregulatory dysfunction in African Americans - An enhanced opportunity for early prevention and treatment of atherosclerotic cardiovascular disease |
| title_short | Microvascular vasoregulatory dysfunction in African Americans - An enhanced opportunity for early prevention and treatment of atherosclerotic cardiovascular disease |
| title_sort | microvascular vasoregulatory dysfunction in african americans an enhanced opportunity for early prevention and treatment of atherosclerotic cardiovascular disease |
| topic | Coronary artery disease Microvascular angina Coronary microvascular dysfunction Endothelial function Cardiometabolic syndrome AHA life's essential 8 |
| url | http://www.sciencedirect.com/science/article/pii/S2666602224000259 |
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