HDL Dysfunctionality (Paraoxonase) Is Worse in Nondiabetic, Postmenopausal African American Than in White Women

African American women (AAW) suffer two- to fourfold greater rates of cardiovascular disease (CVD) mortality and morbidity compared with those in white American women (WAW). The reasons for the higher CVD mortality in African Americans are uncertain. It is generally well established that HDL cholesterol (HDL-C) is antiatherogenic and cardioprotective. Indeed, several prospective studies have revealed that HDL-C is protective of coronary heart disease. Most of these studies were in white populations (1). However, these HDL-C and coronary heart disease relationships do not appear to apply to African Americans. Indeed, AAW have higher HDL-C than WAW. Thus, the higher CVD in AAW in the presence of higher HDL-C is paradoxical and suggests that HDL is possibly less cardioprotective in AAW. We have postulated that in AAW, HDL appears to be qualitatively dysfunctional or AAW are resistant to HDL's cardioprotective effects, i.e., HDL resistance. In this regard, previous studies …