Premature Death Due To Heart Disease And Stroke Takes Much Larger Toll On Black Women

November 09, 1998

DALLAS, Nov. 9 -- Black women face a four-times higher risk of dying before age 60 of either heart disease or stroke than white women, according to one of the largest studies of its kind presented today at the American Heart Association's 71st Scientific Sessions.

"These differences were striking," says Lori Mosca, M.D., Ph.D., director of preventive cardiology research and education at the University of Michigan, Ann Arbor.

Black women who were under age 60 at the time of entry into the study had about a 4.1 times higher risk of dying from heart disease and stroke compared to white women, a difference that persisted over three decades. After adjusting their data to consider differences in the level of education, which is also a strong predictor of early death, the risk fell only slightly.

The study called the Women's Pooling Project -- combining nine investigations that spanned three decades -- included 16,018 white women, 3,655 black women, 1,219 Hispanic women and 91 women of other races and ethnic groups. Women with high blood pressure -- defined as systolic blood pressure (top number) above 140 millimeters/mercury (mm/Hg), diastolic pressure (bottom number) above 89 mm/Hg or those taking medication for the condition -- had five times the risk of dying early from heart disease as did women with normal blood pressure. Women with diabetes had almost five times the risk of non-diabetics. Being obese more than doubled a woman's risk of early death from heart disease and stroke. Smoking and blood cholesterol levels in the top 20 percent for her age group also doubled the risk.

Mosca says that this study emphasizes the need for more widespread screening for risk factors and better treatment of heart disease.

"The No. 1 implication of this study is that risk factors for premature death can be easily identified," says Mosca. "This study shows that a top priority should be blood pressure control and other major priorities should be diabetes control, weight, and blood cholesterol levels, avoiding smoking and increasing physical activity. "We need to understand what factors cause black women to be at such an increased risk for premature death due to heart disease and stroke and why the gap has not improved in 30 years," she says.

Even though risk of dying differed among the races and ethnic groups, researchers found that risk factors for heart disease and stroke were similar between the groups. However, black women have a greater number of risk factors compared to white women and also have a higher risk of death associated with risk factors.

Researchers noticed some strong trends in Hispanic women, but are unable to make any conclusions because most of the women in this group were not enrolled in studies until the 1980s. The limited information on Hispanic women underscores the need for more and better research among disease populations of women, says Mosca.

"This study of nearly 21,000 women is unique because it is the first of its kind to have enough statistical power to look at risk factors for premature death in women, particularly minority women," she says.

The project has combined most of the long-term community-based studies of heart disease in the United States that followed women for at least eight years. Because death from heart disease before age 60 is not common in women, data from thousands of women must be collected to obtain definitive results.

"A single study may not have enough women to look at premature death due to heart disease in women," says Mosca. "So we took advantage of combining information from several existing studies that have followed women up to 30 years. This also allowed us to make ethnic and racial comparisons that might not otherwise be possible in a single study or in a specific geographic area."

Co-authors include Elizabeth Barrett-Connor, M.D.; Ralph B. D'Agostino Sr., Ph.D.; Curtis Hames, M.D.; Victor Hawthorne, M.D.; William B. Kannel, M.D.; Julian Kiel, Dr.P.H.; Braxton Mitchell, Ph.D.; Susan E. Sutherland, Ph.D.; Herman A. Tyroler, M.D.; Moyses Szklo, M.D.; and Millicent Higgens, M.D.
-end-
For more information Nov. 8-11
contact Darcy Spitz or Carole Bullock
Dallas County Convention Ctr.
(214) 853-8056
-end-


American Heart Association

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