Black men with diabetes have dramatically lower amounts of coronary artery disease than diabetic white men, a surprise outcome announced by investigators at Wake Forest University Baptist Medical Center Tuesday.
Dr. Barry Freedman and colleagues report in the December issue of Diabetologia that African-American men had significantly lower levels of calcified atherosclerotic plaque in the coronary arteries and the carotid arteries in the neck that supply blood to the brain.
“This striking result was observed despite black subjects having higher levels of conventional risk factors for heart disease,” said Freedman in a prepared statement. “These risk factors would normally be expected to promote coronary artery disease in the black participants.”
The results came from the Diabetes Heart Study, made up of North Carolina families in which at least two siblings have type 2 or non-insulin-dependent diabetes. The Wake Forest investigators recruited 1,000 white participants from 369 families and 180 blacks from 74 families for the research.
Freedman pointed out that the study was the first to compare blacks and whites who had type 2 diabetes for differences in atherosclerosis. The amount of plaque was measured using high-speed computed tomography (CT) scans.
“Hardening of the arteries appears to be a different disease in blacks and whites. We have demonstrated this in diabetic subjects; other groups have shown it in people with hypertensio,” said Freedman. “We should be studying what causes these biologic differences. Perhaps inherited or genetic influences may contribute to these differences.”

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