Inflammatory biomarkers, race/ethnicity and cardiovascular disease.

Cardiovascular disease (CVD) remains the leading cause of death in the developed world. In the United States alone, cardiovascular disease accounts for nearly 40% of deaths, at an estimated annual cost of at least US $430 billion. Notable, racial/ethnic differences in morbidity and mortality have been observed; in the United States, African Americans have the highest age-adjusted death rate from CVD, followed by Whites, Hispanics, and Asians. The underlying basis for the observed racial/ethnic disparities in CVD morbidity and mortality is likely multifactorial. Although hyperlipidemia screening and treatment has proven to be one of the most effective strategies for reducing CVD burden in the US population, it often fails to identify a substantial proportion of persons at high risk for CVD-related events. Elevations in markers of inflammation and thrombosis such as high sensitivity C-reactive protein, soluble intercellular adhesion molecule, homocysteine, and fibrinogen are also associated with increased CVD risk. However, data relating markers of inflammation and hemostasis to CVD principally come from White populations, little data are available across racial/ethnic groups. A range of barriers exist related to ethnic minority subject participation in research studies in the United States. If we are to better understand the racial differences in cardiovascular risk, these barriers must be overcome.