Little Money, Big Risk

African-Americans at lower socioeconomic levels have increased risk of heart disease, stroke




African-Americans at lower socioeconomic levels, particularly women and younger adults, are at greater risk of heart disease and stroke than those in higher socioeconomic positions, according to research in the Journal of the American Heart Association.

Cardiovascular diseases are the No. 1 killer of all Americans, but the burden is greater for African-Americans. According to the American Heart Association 2015 Statistical Update, nearly half of all African-American adults have some form of CVD, and they are twice as likely as white adults to have a first-ever stroke.

Researchers used data from the Jackson Heart Study, which enrolled 5,301 African-American participants (3,360 women) aged 21 to 94 in the Jackson, Mississippi, area and followed them for up to 10 years. During that time, 362 new or recurrent CVD events were recorded, including heart attacks, heart disease deaths, strokes and cardiovascular procedures. Of these events, 213 were in women and 149 in men.

Researchers found that in African-Americans:

  • Women in the lowest socioeconomic group had more than twice the risk of experiencing a CVD event than those in the highest group.
  • Men and women 50 years and younger in the lowest socioeconomic group had more than three times higher risk of experiencing a CVD event than those in the highest group.

"Our findings underscore the need for increased awareness and education about prevention and early detection and treatment of CVD in African-American women and younger adults of low socioeconomic status," said Samson Y. Gebreab, Ph.D., M.Sc., lead study author and research scientist at the National Human Genome Research Institute in Bethesda, Maryland. "This is especially true because African-Americans generally have less access to health care and are less likely to undertake routine physical examination, despite their increased risk for cardiovascular disease."

After adjusting for other factors like smoking, alcohol use, physical activity, body mass index, type 2 diabetes, hypertension, cholesterol and triglycerides, they found:

  • Being an African-American adult age 50 or younger or an African-American woman of any age remained independent predictors of CVD.
  • By itself, wealth proved to be an independent predictor of CVD in women. Those in the lowest third were 68 percent, and those in the middle third were 61 percent, more likely to experience a CVD event than those in the top third.
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