Young black women demonstrate impaired microvascular but preserved macrovascular function compared to white women

Exp Physiol. 2021 Jun 28. doi: 10.1113/EP089702. Online ahead of print.


NEW FINDINGS: What is the central question of this study? Is there a racial disparity in macrovascular and/or microvascular function between young black and white women? What is the main finding and its importance? Black women (BLW) demonstrated impaired microvascular function but similar macrovascular function compared to white women (WHW). These findings suggest an identifiable racial disparity in microvascular function between BLW and WHW as early as young adulthood. Microvascular dysfunction is predictive of future CVD and generally precedes the development of macrovascular dysfunction. Therefore, these findings also suggest that evaluating microvascular function and CVD risk in young, otherwise healthy BLW are important, as there are known racial disparities in CVD morbidity and mortality in black adults.

ABSTRACT: Black women (BLW) have a higher incidence of cardiovascular disease (CVD) morbidity and mortality compared to white women (WHW). Vascular dysfunction is a non-traditional risk factor for CVD and BLW demonstrate impaired vascular function when compared to WHW throughout the lifespan. Several previous studies assessed macrovascular and microvascular function in young BLW compared to WHW, but there has been no recent work exploring this disparity in young women using current, up-to-date methodologies. Therefore, the purpose of this study was to evaluate both macrovascular and microvascular function as assessed by hemodynamic responses to flow-mediated dilation (FMD), following current FMD guidelines, in young adult BLW and WHW. We hypothesized that BLW would demonstrate attenuated macrovascular and microvascular responses to FMD compared to WHW. Macrovascular function was assessed as the percent dilation of the brachial artery following FMD occlusion-cuff release (FMD%). Microvascular function was assessed by total reactive hyperemia area under the curve (RH AUC), calculated as the cumulative increase in brachial artery blood flow above baseline following FMD occlusion-cuff release. Participants were tested in the morning hours during the early follicular phase of their menstrual cycle. Twenty-eight young, apparently healthy women completed the study: 17 WHW (23±4 years) and 11 BLW (24±5 years). FMD% was lower in BLW (WHW: 8.0±1.6, BLW: 6.2±2.4%) (p = 0.02), however significance was abolished when FMD% was normalized for shear (WHW: 0.1230±0.0388, BLW: 0.1132±0.0405) (p = 0.53). RH AUC was lower in BLW (WHW: 438±133, BLW: 268±66 ml/min) (p<0.001). Young, otherwise healthy BLW demonstrated impaired microvascular function compared to WHW. This article is protected by copyright. All rights reserved.

PMID:34184350 | DOI:10.1113/EP089702