Method: This study took place in the General Clinical Research Center of a southeastern medical center in the US, N=33. AA women age 19-45, were screened for metabolic syndrome and other CV risk factors in a fasting state and underwent a 2 –hour OGTT.  Then various criteria were compared to determine presence for the MS and other early risk markers for CVD.

 Findings: Interestingly, the NCEP guidelines only classified  n = 6 (15.8 %) women as possessing the MS. Whereas, the American Clinical Endocrinology criteria diagnosed n =12 (31.6%) as having MS. The most sensitive single predictor of CV risk was waist circumference which classified n = 18 (47.4 % ) of  women being at risk. Similarly, BMI classified n =17 (44.7%) as being at risk in the overweight to obese categories. A regression equation produced a R² of 0.68 using Plasminogen Activator Inhibitor-1 (PAI-1) as the dependent variable with the predictors of fasting glucose, CRP, and waist circumference; waist circumference was predicted by PAI-1 with an R² of 0.58 and C-Reactive Protein (CRP) was predicted by post-glucose with an R² of 0.50.

 Discussion: As identified in the literature AA women’s risk for CVD is likely significantly underestimated based on the sole use of NCEP criteria. Clinicians should consider a broader definition of risk than contained within the NCEP criteria.  The inclusion of markers of inflammation (CRP) and prothrombotic factors (PAI-1) along with measures of insulin sensitivity may add to early detection of CVD risk, and ultimate reduction in the CV health disparities of these AA women.