Sick Populations and Sick Subpopulations: Reducing Disparities in Cardiovascular Disease Between Blacks and Whites in...

Area of Science:

• Public Health
• Epidemiology
• Cardiovascular Medicine

Background:

• Cardiovascular disease (CVD) death rates are significantly higher among Black populations compared to White populations in the U.S.
• Existing research has not fully elucidated the distribution of CVD risk and events between racial groups or the impact of interventions on these disparities.

Purpose of the Study:

• To develop risk models for fatal and nonfatal CVD.
• To estimate the distribution of CVD risk and events in Black and White adults.
• To assess the impact of various interventions on reducing CVD risk and racial disparities.

Main Methods:

• Utilized data from 8 U.S. cohorts, including 6154 adults aged 50-69 from the National Health and Nutrition Examination Survey (1999-2012).
• Developed risk models for fatal and fatal/nonfatal CVD.
• Estimated the impact of population-wide, targeted, and risk-based interventions on 10-year CVD risks and event rates.

Main Results:

• A higher percentage of Black men (25%) and women (12%) faced high risk (≥6.67%) of fatal CVD compared to White men (10%) and women (3%).
• High-risk Black individuals accounted for a larger proportion of CVD deaths (55% in men, 42% in women) than high-risk White individuals (30% in men, 18% in women).
• An intervention targeting multiple risk factors in high-risk individuals could reduce the Black-White CVD death rate disparity from 1659 to 1244 per 100,000 in men and 1320 to 897 in women.

Conclusions:

• Black individuals disproportionately experience high fatal CVD risk and contribute significantly to CVD mortality.
• Risk-based interventions that address multiple risk factors show potential to substantially decrease overall CVD rates and mitigate racial disparities in CVD mortality.