 |
|
Comparison of Risk Factors for Cardiovascular Mortality in Black and White Adults
Mercedes R. Carnethon, PhD;
Elizabeth B. Lynch, PhD;
Alan R. Dyer, PhD;
Donald M. Lloyd-Jones, MD, ScM;
Renwei Wang, MS;
Daniel B. Garside, BS;
Philip Greenland, MD
Arch Intern Med. 2006;166:1196-1202.
Background Recent attention to racial and ethnic disparities in health outcomes highlights the excess coronary heart disease mortality in black patients compared with white patients. We investigated whether traditional cardiovascular disease (CVD) risk factors were similarly associated with CVD mortality in black and white men and women.
Methods Participants included 3741 black and 33 246 white men and women (44%) without a history of myocardial infarction, aged 18 to 64 years at baseline (1967-1973) from the Chicago Heart Association Detection Project in Industry study. Blood pressure, total cholesterol level, body mass index, cigarette smoking, and physician-diagnosed diabetes were assessed at baseline using standard methods.
Results Through 2002, there were 107, 1586, 177, and 2866 deaths from CVD in black women, white women, black men, and white men, respectively. In general, the magnitude and direction of associations between traditional risk factors and CVD mortality were similar by race. However, in black women the multivariable-adjusted hazard ratio (HR) per 12 mm Hg of diastolic blood pressure was 1.08 (95% confidence interval [CI], 0.90-1.29), whereas it was 1.31 in white women (95% CI, 1.25-1.38). There was no association between higher cholesterol level (per 40 mg/dL [1.04 mmol/L]) and CVD mortality in black men (HR, 0.94; 95% CI, 0.80-1.10), whereas the risk was elevated in white men (HR, 1.21; 95% CI, 1.16-1.26).
Conclusions Most traditional risk factors demonstrated similar associations with mortality in black and white adults of the same sex. Small differences were primarily in the strength, not the direction, of association.
Author Affiliations: Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Ill.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Heart Disease and Stroke Statistics--2008 Update: A Report From the American Heart Association Statistics Committee and Stroke Statistics Subcommittee
Rosamond et al.
Circulation 2008;117:e25-e146.
FULL TEXT
Absolute and Attributable Risks of Cardiovascular Disease Incidence in Relation to Optimal and Borderline Risk Factors: Comparison of African American With White Subjects--Atherosclerosis Risk in Communities Study
Hozawa et al.
Arch Intern Med 2007;167:573-579.
ABSTRACT
| FULL TEXT
|
