Racial and Ethnic Differences in Long-Term Cardiovascular Mortality Among Women and Men From the CAC Consortium

Area of Science:

• Cardiology
• Public Health
• Health Disparities Research

Background:

• Racial and ethnic disparities in atherosclerotic cardiovascular disease (ASCVD) risk assessment are not well understood.
• An increasingly diverse population necessitates a closer examination of these disparities.

Purpose of the Study:

• To compare cardiovascular (CV) mortality based on ASCVD risk and coronary artery calcium (CAC) scores among Black and Hispanic individuals versus other populations.
• To investigate sex-specific differences in CV mortality within these racial and ethnic groups.

Main Methods:

• Analysis of 42,964 participants from the CAC Consortium with self-reported race and ethnicity.
• Utilized multivariable Cox proportional hazards regression models to estimate CV mortality, with separate analyses for men and women.
• Median follow-up duration was 11.7 years.

Main Results:

• Black women and men exhibited higher ASCVD risk and CAC scores, correlating with the highest CV mortality.
• Black individuals with a CAC score of 0 or an ASCVD risk score <5% had 6- to 9-fold higher CV mortality compared to others.
• Hispanic individuals showed intermediate CV mortality, with notable increased risk observed in men with CAC scores of 0 or ≥100.

Conclusions:

• Disproportionately high CV mortality among Black women and men indicates significant barriers in current ASCVD risk assessment strategies.
• Effective reduction of ASCVD burden requires addressing these identified racial and ethnic disparities in risk assessment and outcomes.