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Cardiovascular Disease Burden and Socioeconomic Correlates: Findings From the Jackson Heart Study
Yuan-I Min1, Pramod Anugu2, Kenneth R Butler2
1University of Mississippi Medical Center, Jackson, MS ymin@umc.edu.
Insights
Black individuals experience a higher burden of cardiovascular disease (CVD) than white individuals. This study found elevated CVD rates and a significant socioeconomic gradient within the Jackson Heart Study cohort.
Area of Science:
- Public Health
- Epidemiology
- Cardiovascular Disease Research
Background:
- Black persons exhibit a disproportionately high burden of cardiovascular disease (CVD) compared to white persons.
- This disparity persists even after accounting for socioeconomic status and other known CVD risk factors.
- The Jackson Heart Study (JHS) investigates CVD burden and socioeconomic factors among Black participants.
Purpose of the Study:
- To evaluate the prevalence and burden of CVD within the JHS cohort.
- To examine the socioeconomic gradient of CVD among Black individuals.
- To compare CVD prevalence in the JHS cohort with US national data.
Main Methods:
- CVD burden was assessed by comparing observed prevalence of myocardial infarction, stroke, and hypertension in JHS with expected US national prevalence.
- Socioeconomic gradient of CVD was analyzed using logistic regression models.
- Prevalence ratios and odds ratios were calculated, adjusting for age and sex.
Main Results:
- The JHS cohort showed higher than expected age- and sex-standardized prevalence ratios for myocardial infarction (men: 1.07, women: 1.50), stroke (men: 1.46, women: 1.33), and hypertension (men: 1.51, women: 1.43) compared to national data.
- A significant inverse relationship was found between socioeconomic status and CVD within the JHS cohort.
- Income was the strongest socioeconomic correlate for myocardial infarction and stroke, with lower income associated with higher odds.
Conclusions:
- Cardiovascular disease burden in the JHS cohort was generally higher than expected, with the exception of myocardial infarction in men.
- A pronounced inverse socioeconomic gradient of CVD exists within the Black population studied.
- Findings highlight the need for targeted interventions addressing socioeconomic disparities in CVD prevention and management for Black individuals.
Background:
Black persons have an excess burden of cardiovascular disease (CVD) compared with white persons. This burden persists after adjustment for socioeconomic status and other known CVD risk factors. This study evaluated the CVD burden and the socioeconomic gradient of CVD among black participants in the JHS (Jackson Heart Study).
Methods And Results:
CVD burden was evaluated by comparing the observed prevalence of myocardial infarction, stroke, and hypertension in the JHS at baseline (2000-2004) with the expected prevalence according to US national surveys during a similar time period. The socioeconomic gradient of CVD was evaluated using logistic regression models. Compared with the national data, the JHS age- and sex-standardized prevalence ratios for myocardial infarction, stroke, and hypertension were 1.07 (95% CI, 0.90-1.27), 1.46 (95% CI, 1.18-1.78), and 1.51 (95% CI, 1.42-1.60), respectively, in men and 1.50 (95% CI, 1.27-1.76), 1.33 (95% CI, 1.12-1.57), and 1.43 (95% CI, 1.37-1.50), respectively, in women. A significant and inverse relationship was observed between socioeconomic status and CVD within the JHS cohort. The strongest and most consistent socioeconomic correlate after adjusting for age and sex was income for myocardial infarction (odds ratio: 3.53; 95% CI, 2.31-5.40) and stroke (odds ratio: 3.73; 95% CI, 2.32-5.97), comparing the poor and affluent income categories.
Conclusions:
Except for myocardial infarction in men, CVD burden in the JHS cohort was higher than expected. A strong inverse socioeconomic gradient of CVD was also observed within the JHS cohort.
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