Black race is associated with digital artery endothelial dysfunction: results from the Heart SCORE study

Aims We evaluated whether black race is independently associated with arterial endothelial dysfunction. The pathophysio-logical basis for race-related differences in cardiovascular disease (CVD) risk has not been established. Endothelial dysfunction, which precedes obstructive atherosclerotic disease, may contribute to CVD disparities. Accordingly, we evaluated race-related differences in digital pulse amplitude tonometry (PAT) response to an endothelium-depen-dent vasodilatory stimulus. Methods and results A total of 1377 subjects (41 % black; mean age 58.5+ 7.5 years; 67 % female) enrolled in the Heart Strategies Con-centrating on Risk Evaluation (Heart SCORE) study underwent assessment of digital pulse amplitude response to forearm occlusion-induced hyperaemia. The response was measured as a PAT ratio of hyperaemia:baseline pulse amplitude in a finger that was subject to hyperaemic stimulus divided by this same ratio in a control finger on the contralateral arm which did not undergo forearm occlusion, expressed as the natural logarithm. The average PAT ratio was significantly lower in blacks compared with whites (0.67+ 0.44 vs. 0.80+0.46, P, 0.001), signifyin