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Mortality rates and risk factors for coronary disease in black as compared with white men and women
J E Keil1, S E Sutherland, R G Knapp
1Charleston Heart Study, Medical University of South Carolina 29425-2239.
Insights
This 30-year study found that major risk factors for coronary artery disease mortality, including blood pressure, cholesterol, and smoking, are similar across racial groups. Education level also impacted coronary disease death rates.
Area of Science:
- Cardiovascular epidemiology
- Public health research
- Racial health disparities
Background:
- Established coronary artery disease (CAD) risk factors are primarily derived from studies on white populations.
- This study aimed to assess CAD mortality rates and identify associated risk factors in both white and black populations.
Purpose of the Study:
- To estimate and compare mortality rates for coronary artery disease (CAD) and all-cause mortality between white and black men and women.
- To identify significant risk factors for CAD-related death within these demographic groups over a 30-year period.
Main Methods:
- Utilized data from the Charleston Heart Study, spanning 30 years.
- Assessed mortality rates and risk factor associations from baseline examinations in 1960-1961 for 653 white men, 333 black men, 741 white women, and 454 black women.
Main Results:
- No statistically significant racial differences were observed in the rate ratios for coronary disease death; however, women exhibited lower mortality rates than men.
- Key predictors of coronary disease mortality included systolic blood pressure (all groups), serum cholesterol (white men, white women, black women), and smoking (white men, white women, black men).
- Diabetes showed a consistent, though not statistically significant, increased risk of CAD death across all groups. Higher education was linked to lower CAD mortality in white men and black women. All-cause mortality rates were higher for black individuals compared to white individuals.
Conclusions:
- While minor differences in coronary disease death rates existed between black and white men and women, these were not statistically significant.
- The primary risk factors for coronary artery disease mortality were found to be consistent across racial groups in this long-term study.
- This research highlights the importance of considering similar risk factor management strategies for coronary artery disease across diverse populations.
Background:
Currently recognized risk factors for coronary artery disease have been identified primarily from investigations of white populations. In this investigation, we estimated mortality rates for coronary disease and for any cause and identified risk factors for death from coronary disease among whites and blacks.
Methods:
Data collected over a 30-year period in the Charleston Heart Study were used to estimate mortality rates and quantify associations with risk factors assessed at the base-line examination in 1960 and 1961 of 653 white men, 333 black men, 741 white women, and 454 black women.
Results:
There were no significant racial differences in the rate ratios for death from coronary disease; however, women had significantly lower death rates than men. Over the 30-year period, the mortality rates for coronary disease per 1000 person-years were 5.2 for white men (95 percent confidence interval, 4.1 to 6.3), 4.6 for black men (3.0 to 6.2), 2.1 for white women (1.6 to 2.6), and 3.2 for black women (2.3 to 4.0). Significant, or nearly significant, predictors of mortality due to coronary disease were systolic blood pressure in all four groups; serum cholesterol level among white men, white women, and black women; and smoking among white men, white women, and black men. Although the difference was not statistically significant, the risk of death from coronary disease was consistently increased among diabetics in all four groups. A higher level of education was predictive of lower rates of death due to coronary disease among white men and black women. For all causes of death taken together, the rates for blacks were higher than the rates for whites. The presence of hypertension, a history of smoking, and a history of diabetes were significant or nearly significant predictors of mortality from any cause in all four groups.
Conclusions:
Although the rates of death from coronary disease were somewhat lower among black men than white men and higher among black women than white women, the black:white mortality rate ratios were not statistically significant, and the major risk factors for mortality from coronary disease were similar in blacks and whites in the 30-year follow-up of the Charleston Heart Study.
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