Epidemiology and epigenetics of cardiovascular risk in African migrants

Sub-Saharan African (SSA) migrants in Europe are disproportionally affected by cardiovascular disease (CVD). Hypertension, dyslipidaemia, and metabolic syndrome are considered to be among the main risk drivers behind this high burden of CVD in SSA migrant populations. However, the extent of the burden of these CVD risk factors in these populations has not been systematically described. Additionally, underlying mechanisms – including epigenetic modifications – responsible for the high prevalence of these risk factors in SSA migrant populations remain to be elucidated. The aim of this thesis was to systematically assess the burden, epidemiological and epigenetic determinants of CVD risk factors in SSA migrants. The results show that SSA migrants are half as likely to have their hypertension controlled, compared to the European host population. About one-third of SSA migrants in Europe has metabolic syndrome, and half of the SSA migrant population has dyslipidaemia. Modifiable risk factors, especially obesity, are main contributors to the high prevalence of CVD risk among SSA populations. Also, epigenetic loci are associated with plasma lipid levels, and with hormones involved in blood pressure regulation. The reported high burden of CVD risk among SSA migrants in Europe does not bode well for future trends in CVD prevalence among these populations if preventative measures are not put into place. Replicative studies among other SSA populations, as well as longitudinal studies are required to further unravel pathophysiological mechanisms underlying CVD burden in SSA migrants and to mitigate the excessive burden of CVD risk among SSA migrant populations.