Nontraditional cardiovascular risk factors common in overweight black youth

Chicago, IL – Doctors should screen for non-traditional cardiovascular risk factors when assessing heart disease risk in overweight black adolescents, according to a new study from a Memphis researcher released at the American Heart Association’s Scientific Sessions today in Chicago.

Childhood obesity is linked to the development of cardiovascular disease and death in adulthood. However, black youth are not routinely assessed for cardiovascular risk factors.

To predict the number of cardiac risk factors in overweight and obese black teens, researchers examined the interaction of the severity of obesity, insulin resistance, family history of heart attack, diet and physical activity in 122 black teens (average age 15).

They found that, on average, overweight and obese black teenagers had four risk factors for cardiovascular disease, and 36 percent had five or more risk factors.

Commonly assessed risk factors seen in about half of the youth included:

• 55 percent with high blood pressure;
• 47.5 percent with low “good” high density lipoprotein (HDL) cholesterol; and
• More than 50 percent with risk factors for inflammation and clots (not routinely checked in teenagers).

Age, pubertal status, family history of heart attack, severity of obesity and insulin resistance predicted the number of risk factors present in overweight and obese black teenagers. Diet and physical activity did not predict cardiovascular risk factors. This may be due to the children’s low level of physical activity and high fat intake, researchers said.

Based on these findings, children who are younger, earlier in puberty, more seriously obese, with greater insulin resistance and a positive family history of heart attack would have more cardiovascular risk factors.

Doctors should assess youth for insulin resistance, family history of early heart attack and use blood pressure percentile charts to determine hypertension. Incorporating screenings for inflammation and thrombosis will aid in risk stratification and earlier intervention, researchers said.

Contact: Patricia A. Cowan, Ph.D., associate professor, College of Nursing, University of Tennessee Health Science Center, Memphis, TN; 901-448-3318; PCowan@uthsc.edu.