• Blood pressure-related differences in brain health between young African Americans and Caucasian Americans

      Won, Junyeon; Ranadive, Sushant M; Callow, Daniel D; Chen, Shuo; Smith, J. Carson (Wiley-Blackwell, 2021-03-26)
      Background: Although there are moderating effects of race on blood pressure (BP) and brain health in older adults, it is currently unknown if these race-related differences in cardiovascular and associated brain function are also present in younger adults. The purpose of this study was to investigate the interaction between race and BP on brain health in younger African (AA) and Caucasian Americans (CA). Methods: We studied 971 younger adults (29.1 ± 3.5 years; 180 AAs and 791 CAs) who volunteered to participate in the Human Connectome Project. Cognitive composite scores, brain volume, and cortical thickness using MRI were cross-sectionally assessed. ANCOVA was used to examine interactions between race and mean arterial pressure (MAP) on cognitive test scores and brain structure. Results: After controlling for age, sex, education, and BMI, there were significant Race × MAP interaction effects on cognitive composite scores and cortical thickness. Among AAs but not CAs, as MAP increased, both global cognitive performance and entorhinal cortex (ERC) thickness decreased. Conclusions: MAP was an important moderator of racial differences in cognitive performance and ERC thickness. Our findings suggest that young AAs may carry a greater hypertension-associated risk for cognitive brain health deficit. Interventions that address early signs of hypertension in AAs are needed to determine if the racial disparities in BP-related brain health in late adulthood can be reduced. © 2021 The Authors.
    • Cross-Cultural Measurement Invariance of a Measure of Disability for White, Black, Hispanic and Asian Older Adults

      Chan, Keith T; Algood, Carl; Prifti, Andreana; Zidan, Tarek (MDPI AG, 2021-02-03)
      The results indicated that the measure was valid for use with older adults (Satorra Bentler χ2 = 13.27, df = 3, p = 0.005, GFI = 0.996). Multi-group CFA indicated comparisons were valid between Whites with Blacks, and Hispanics with Asians. Cognitive disability was associated with independent living disability for Whites and Blacks, and with sensory disability for Hispanics and Asians.
    • Race Differences in High-Grade Carotid Artery Stenosis

      Lal, Brajesh K; Meschia, James F; Brott, Thomas G; Jones, Michael; Aronow, Herbert D; Lackey, Angelica; Howard, George (Lippincott Williams and Wilkins, 2021-05-04)
      Background and Purpose: Despite a higher incidence of stroke and a more adverse cardiovascular risk factor profile in Blacks and Hispanics compared with Whites, carotid artery revascularization is performed less frequently among these subpopulations. We assessed racial differences in high-grade (≥70% diameter-reducing) carotid stenosis. Methods: Consecutive clients in a Nationwide Life Line for-Profit Service to screen for vascular disease, 2005 to 2019 were evaluated in a cross-sectional study. The prevalence of high-grade stenosis, defined by a carotid ultrasound peak systolic velocity of ≥230 cm/s, was assessed. Participants self-identified as White, Black, Hispanic, Asian, Native American, or other. Race/ethnic differences were assessed using Poisson regression. The number of individuals in the United States with high-grade stenosis was estimated by applying prevalence estimates to 2015 US Census population estimates. Results: The prevalence of high-grade carotid stenosis was estimated in 6 130 481 individuals. The prevalence of high-grade stenosis was higher with increasing age in all race-sex strata. Generally, Blacks and Hispanics had a lower prevalence of high-grade stenosis compared with Whites, while Native Americans had a higher prevalence. For example, for men aged 55 to 65, the relative risk of stenosis compared with Whites was 0.40 (95% CI, 0.29-0.55) and 0.61 (95% CI, 0.46-0.81) for Blacks and Hispanics, respectively; and 1.53 (95% CI, 1.12-2.10) for Native Americans. When these prevalence estimates were applied to the Census estimates of the US population, an estimated 327 721 individuals have high-grade stenosis, of whom 7% are Black, 7% Hispanic, and 43% women. Conclusions: Despite their having a more adverse cardiovascular risk profile, there was a lower prevalence of high-grade carotid artery stenosis for both the Black and Hispanic relative to the White clients. This lower prevalence of high-grade stenosis is a potential contributor to the lower use of carotid revascularization procedures in these minority populations.
    • Race-based differences in drug use prior to onset of opioid use disorder

      Deutsch-Link, Sasha; Belcher, Annabelle M; Massey, Ebonie; Cole, Thomas O; Wagner, Michael A; Billing, Amy S; Greenblatt, Aaron D; Weintraub, Eric; Wish, Eric D (Routledge, 2021-02-07)
      Rates of opioid use disorder (OUD) have increased dramatically over the past two decades, a rise that has been accompanied by changing demographics of those affected. Early exposure to drugs is a known risk factor for later development of opioid use disorder; but how and whether this risk factor may differ between racial groups is unknown. Our study seeks to identify race differences in self-report of current and past substance use in OUD-diagnosed treatment-seeking individuals. Patients (n = 157) presenting for methadone maintenance treatment at a racially diverse urban opioid treatment program were approached and consented for study involvement. Participants were administered substance use history questionnaires and urine drug screening at intake. Chi-square, t-tests, and rank-sum were used to assess race differences in demographic variables. Logistic and linear regressions assessed the relationship between race and substance use for binary and continuous variables, respectively. 61% of the population identified as Black and 39% as White. Black participants were significantly older; age was thus included as a covariate. Logistic regressions demonstrated that despite similar urine toxicology at intake, White participants were significantly more likely to report having used prescription opioids and psychedelic, stimulant, and sedative substance classes prior to their first use of non-pharmaceutical opioids. Compared to Black participants, White treatment-seeking OUD-diagnosed individuals reported using a wider range of substances ever and prior to first use of non-pharmaceutical opioids. There were no differences, however, in presentation for OUD treatment, suggesting different pathways to OUD, which may carry important clinical implications. © 2021 The Author(s).