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Racial Disparities In Heart Disease


By Edyta Zielinska

Racial Disparities in Heart Disease: A Close Look at ClottingBlack Americans are more likely to have heart disease and more likely to die from the disease. While disparities in healthcare access and bias certainly play a role, new research from Paul Bray, M.D., Director of the Cardeza Foundation of Hematologic Research at Jefferson suggest that differences in genetic make-up may also play a role.

One of Dr. Bray and colleagues' key discoveries is that the platelets — a cell circulating in the blood stream that causes clots in heart vessels – of Black Americans are "hyper-sensitive" to thrombin, a blood clotting agent. This racial difference is caused by a slight variation in the genetic code of the platelet protein called PAR4, making platelets from blacks "stickier" than platelets from whites. Further studies from Dr. Bray's laboratory suggest that heart disease in black patients might not be held in check by most of the currently FDA-approved heart medications that work by blocking blood clots (known as blood thinners). Notably, although the newly identified PAR4 risk variant is most common in blacks, it is also present in smaller percentages of individuals of non-African ancestry.

With the government R01 grant recently received by Dr. Bray's lab, the researchers plan to bore further down into how the PAR4 gene variant resists common blood thinners and also screen large databases of patient data to determine if having the PAR4 variant predisposes patients to heart disease or to worse outcomes despite current best care. The group is screening drug libraries to identify better drugs to treat patients with PAR4 risk variant, and will also work to understand how to use and dose currently approved medications so that they are more effective at treating patients with the PAR4 gene variant.

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