Racial disparities in incident and recurrent cardiovascular events: the Multi-Ethnic Study of Atherosclerosis

Area of Science:

• Cardiovascular epidemiology
• Health disparities research
• Racial and ethnic health differences

Background:

• Previous cardiovascular disease (CVD) research predominantly focused on initial (incident) events.
• Understanding differences in both incident and recurrent CVD events across diverse populations is crucial for targeted interventions.

Purpose of the Study:

• To analyze racial and ethnic disparities in both incident and recurrent cardiovascular disease (CVD) events.
• To compare revascularization rates and CVD mortality among different racial and ethnic groups.

Main Methods:

• Utilized data from the Multi-Ethnic Study of Atherosclerosis (2000-2019).
• Employed joint and multivariable adjusted Cox proportional hazards modeling.
• Analyzed incident and recurrent CVD events in 6,814 participants aged 45-85 without known CVD at baseline.

Main Results:

• Black participants showed lower or similar rates of incident and recurrent CVD events compared to White participants.
• Revascularization rates were significantly lower in Black versus White participants (3.8 vs 6.4 per 1000 person-years).
• Adjusted hazard for CVD mortality was substantially higher for Black versus White participants (HR 1.85).

Conclusions:

• Despite similar or lower event rates, Black individuals face a higher risk of fatal cardiovascular disease (CVD).
• Lower revascularization rates in Black participants may contribute to poorer outcomes.
• Findings underscore significant racial disparities in cardiovascular health and mortality.