Racial Difference in Hypertriglyceridemia and Its Impact on Coronary Heart Diseases

Abstract

Lead Author's Financial Disclosures Nothing to disclose. Study Funding None. Background/Synopsis Hypertriglyceridemia (HTG) is a known independent risk factor for coronary heart disease (CHD). However, there has been a paucity of data on the racial difference in patients with HTG and its association with CHD. Objective/Purpose To identify the effects of race on development of hypertriglyceridemia and associated complications. Methods We conducted a retrospective analysis of the 2016 to 2018 Nationwide Inpatient Sample. Adult patients with HTG (age ≥ 18) were selected using the ICD-10 diagnosis code. Discharge-level weight analysis was used to produce a national estimate. A univariate and multivariable hierarchical regression analysis were performed to calculate odds ratio (OR). Results During the study period, 90,856,281 patients were hospitalized of which 350,250 (0.39%) had HTG. The most common races patients identified themselves as, in descending order of frequency, were White (69.7%), Hispanic (14.5%), Black (8.8%), Asian (3.4%), and Native American (0.4%). The population with the highest prevalence of HTG was Hispanic (0.5%), followed by Asian (0.48%), Native American (0.41%), White (0.4%), and Black (0.22%). After adjusting for age, sex, obesity, and comorbidity burden, Black (OR 0.46; p < 0.001) and Native American races (OR 0.86; p = 0.001) decreased the risk of HTG and Hispanic (OR 1.14; p < 0.001) and Asian (OR 1.33; p < 0.001) populations had the elevated risk of it compared to White population. Among those who developed HTG, Asian patients had the lowest proportion of obesity (BMI > 30) (19.5%; mean 33.1% of whole population) and White patients had the lowest prevalence of diabetes (47.4%; mean 49.7%). After adjusting for age, sex and comorbidity burden, Black (OR 0.69; p < 0.001), Hispanic (OR 0.73; p < 0.001) and Asian (OR 0.75; p < 0.001) populations were related to lower risk of CHD compared to White race. There was no significant difference in hospital mortality of CHD among different races (p=0.33). Also, race did not affect the risk of ischemic or hemorrhagic strokes in patients with HTG(p=0.39). Conclusions The incidence of HTG was the highest in Hispanic and the lowest in Native American races. Also, Hispanic and Asian populations were associated with elevated risk of HTG. White patients with HTG were at higher risk of CHD than other ethnicities. Further studies are need to understand the racial-specific risk factors contributing to the observed difference in HTG and CHD. Nothing to disclose.