The American journal of the medical sciences
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The importance of traditional coronary artery disease risk factors in the development of coronary heart disease is well known. African Americans have a higher prevalence of such risk factors as hypertension, diabetes mellitus, obesity, cigarette smoking, and left ventricular hypertrophy, which might account for the disproportionate rate of coronary heart disease mortality in African Americans. Compelling data from randomized lipid-lowering trials show conclusively that lowering cholesterol levels, specifically low-density lipoprotein cholesterol, lowers coronary heart disease morbidity and mortality. ⋯ Diabetes mellitus, cigarette use, physical inactivity, stress, and obesity play critical roles collectively and individually in increasing coronary heart disease, morbidity, and mortality. Clustering of coronary heart disease risk factors in African Americans must be strongly considered to play a critical role in the excess mortality from coronary heart disease seen in African Americans. New innovative approaches are required if the course of coronary heart disease is to be altered.
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The Jackson Heart Study is a partnership among Jackson State University, Tougaloo College, the University of Mississippi Medical Center and the National Institutes of Health's National Heart, Lung, and Blood Institute (NHLBI) and Office of Research on Minority Health. The purposes of the study are to: (1) establish a single-site cohort study to identify the risk factors for the development of cardiovascular diseases, especially those related to hypertension, in African American men and women; (2) build research capabilities in minority institutions by building partnerships; (3) attract minority students to careers in public health and epidemiology; and (4) establish an NHLBI Field Site in Jackson, Mississippi, similar to those established for the Framingham Heart Study and the Honolulu Heart Program. ⋯ The study will have a sample size of approximately 6,500 men and women aged 35-84 years and will include approximately 400 families. Exam 1 is scheduled to take place in the spring of the year 2000.
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Hypertension, left ventricular hypertrophy (LVH), hypercreatininemia, and microalbuminuria (MA) are independent risk factors for cardiovascular disease (CVD). Hypertension increases the risk of CVD by two- to three-fold and LVH (especially concentric) is a risk factor for coronary heart disease, heart failure, stroke, and peripheral arterial disease. ⋯ Impaired renal sodium handling and sodium retention are physiological hallmarks of the very early stages of heart failure. Heart failure is a physiologically delicate condition that can decompensate with excess dietary salt intake or over diuresis, or compensate with cautious therapy designed to block the sodium retention and simultaneously interrupt excessively activated neurohumoral mechanisms.