Elsevier

Cardiology Clinics

Volume 33, Issue 2, May 2015, Pages 325-333
Cardiology Clinics

Dyslipidemia in Special Ethnic Populations

https://doi.org/10.1016/j.ccl.2015.01.005Get rights and content

Section snippets

Key points

  • Among racial/ethnic groups, Asian Indians, Filipinos and Hispanics are at greater risk for dyslipidemia, which is consistent with the higher coronary heart disease (CHD) mortality rates.

  • Compared with other racial/ethnic groups, statins may have a higher efficacy for Asians. Studies suggest lower starting dosage in Asians, but the data are mixed.

  • Genetic differences in statin metabolism can in part explain this racial/ethnic difference in statin sensitivity and adverse effects.

  • Lifestyle

Prevalence of dyslipidemia subtypes among special racial/ethnic groups

The NHANES is the primary data source for national prevalence rates of dyslipidemia in the United States, sampling mainly non-Hispanic whites (whites), non-Hispanic blacks (blacks), and Mexican Americans. The NHANES has very limited samples from the Asian subgroups.4 Other data sources, such as primary care settings and observational studies, contribute to a comprehensive picture of racial/ethnic differences in dyslipidemia by providing important information about races and ethnicities that are

Dyslipidemia-related mortality in special racial/ethnic groups

Dyslipidemia often results in an increased risk of premature atherosclerosis, a major risk factor for CHD.15 CHD is the leading cause of mortality for both men and women in the United States and worldwide, with increasing evidence of gender and racial/ethnic minority disparities in CHD morbidity and mortality.16, 17, 18, 19 Despite declines in CHD death rates over the past decades, CHD contributes to more than one-third of all deaths for those over the age of 35 years.20

Differences in mortality

Overview

There are several US Food and Drug Administration (FDA)-approved 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase inhibitors (statins) and a variety of nonstatin therapies available for the treatment of dyslipidemia, including bile acids sequestrants, cholesterol absorption inhibitors, fibrates, niacin, and omega-3 fatty acids. Statins are the most widely prescribed treatment for dyslipidemia, and one of the most commonly prescribed drugs in the United States.32 In the most recent national

Summary

There are significant racial/ethnic differences in dyslipidemia prevalence, dyslipidemia-related mortality rates, and response to lipid-lowering agents. Among all racial/ethnic groups, Asian Indians, Filipinos and Hispanics are at most elevated risk for dyslipidemia, which is consistent with the higher CHD mortality rates in these groups. More attention should be paid to these at-risk groups for screening and treatment purposes. Compared with other racial/ethnic groups, statins may have a

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    Conflicts of Interest: All authors declare they have no conflicts of interest.

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