Black-white differences in aortic fatty streaks in adolescence and early adulthood: the Bogalusa Heart Study

Although white adults have more extensive aortic surface involvement with fibrous plaques than do blacks, adolescent blacks have more aortic fatty streaks (FS) than do whites of similar ages. Possible determinants of these racial differences in aortic surface involvement with FS were therefore examined in 44 decedents who had previously been examined as part of the Bogalusa Heart Study. Ages at death ranged from 6 to 27 years (mean, 18 years); the median interval between the last risk factor examination and death was 3.5 years. More extensive aortic surface involvement with FS was observed in blacks (n = 11) as compared with whites (n = 33; 37% vs 16%, p = .0003). This racial difference was independent of age at death, and was seen in both male and female subjects. Black-white differences in several of the previously measured risk factors (serum lipids and lipoproteins, blood pressure, and obesity) were also observed, and in both races, aortic FS were related to several of these characteristics. (For example, the correlation between levels of low-density lipoprotein cholesterol and aortic FS was 0.49 in whites and 0.73 in blacks.) However, even after controlling for antemortem levels of risk factors, blacks had an additional 16% surface involvement with aortic FS as compared with whites (p less than .001). These findings suggest that the more extensive surface involvement of the aorta with FS in young blacks is not due to differences in clinical risk factors. Because more extensive raised lesions are found in white adults, the transition of FS to advanced atherosclerotic lesions may differ in whites and blacks.