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Race/ethnicity, income, major risk factors, and cardiovascular disease mortality

Avis J Thomas1, Lynn E Eberly, George Davey Smith

  • 1Coordinating Centers for Biometric Research, University of Minnesota, 2221 University Ave SE, Suite 200, Minneapolis, MN 55414, USA. avist@ccbr.umn.edu

American Journal of Public Health
|July 12, 2005
PubMed

Insights

Cardiovascular disease (CVD) mortality is higher in Black men, but risk factors and income largely explain this difference. Prevention efforts targeting these factors are crucial for reducing CVD disparities.

Area of Science:

  • Cardiovascular epidemiology
  • Health disparities research
  • Preventive cardiology

Background:

  • Cardiovascular disease (CVD) remains a leading cause of mortality.
  • Significant disparities in CVD mortality exist between racial groups.
  • Understanding the role of risk factors in these disparities is critical for targeted interventions.

Purpose of the Study:

  • To investigate disparities in cardiovascular disease (CVD) mortality between Black and White men.
  • To examine how major CVD risk factors influence these mortality differences.
  • To stratify CVD mortality risk by levels of major risk factors within racial groups.

Main Methods:

  • Analysis of data from 320,870 men (300,647 White, 20,223 Black) aged 35-57 from the Multiple Risk Factor Intervention Trial (MRFIT).
  • Calculation of hazard ratios for CVD deaths over 25 years of follow-up.
  • Stratification of analyses by levels of major CVD risk factors and income.

Main Results:

  • The age-adjusted CVD hazard ratio for Black men compared to White men was 1.35.
  • After adjusting for risk factors and income, the ratio decreased to 1.05.
  • CVD mortality rates were lower with favorable risk profiles; however, Black men still had higher mortality at low and intermediate risk levels.

Conclusions:

  • Cardiovascular disease mortality disparities between Black and White men are substantially mediated by risk factors and income.
  • These findings highlight the importance of primordial prevention of risk factors, particularly in Black men.
  • Sustained public health efforts are needed to address CVD risk factor prevalence and reduce mortality inequities.
Abstract

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