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Chart 10. African Americans (AAs)
Recommendations
Strength Quality
In general, AAs should be treated according to the NLA
Recommendations for Patient-Centered Management
of Dyslipidemia – Part 1 with the following special
considerations.
A High
Clinicians should be aware that AAs as a group are at
increased risk for ASCVD.
A High
Because attributable ASCVD risk in AAs is less driven by
dyslipidemia than in NHWs, particular attention should be
given to assessing non-lipid risk factors, such as hypertension,
overweight and obesity, type 2 diabetes mellitus, and physical
inactivity, when ascertaining ASCVD risk.
A High
AAs have a lower incidence of metabolic syndrome than
NHWs, due to lower prevalence of high TG and low
HDL-C. However, the incidence of type 2 diabetes mellitus
is higher in AAs.
A High
Because AA race/ethnicity is included in the 2013 ACC/
AHA Pooled Cohort Equations for estimating 10-year
ASCVD risk, this may be the preferable risk calculator to use
in patients of AA race/ethnicity.
B Moderate
Because Lp(a) levels tend to be higher in AA patients,
measuring Lp(a) for risk refinement may be considered in
AA patients, particularly in those with a family history of
premature ASCVD not explained by other risk factors.
E Moderate
Clinicians should not withhold statin therapy from at risk
AA patients with asymptomatic creatine kinase levels that
exceed, but are <3.0 times, the standard upper limits of
normal. When practical, normative upper limits for creatine
kinase that are adjusted for age, race, and sex should be used.
E Moderate
