Despite declines in heart disease deaths, racial gap remains

November 11, 2001

ANAHEIM, Calif. Nov. 11 - Despite recent declines in coronary heart disease (CHD) death rates, a disparity between African Americans and whites has increased, according to a study reported today at the American Heart Association's Scientific Sessions 2001 conference.

CHD death rates among both whites and blacks dropped over the last two decades, but the reduction was more modest in African Americans, says Zhi-Jie Zheng, M.D., Ph.D., an epidemiologist in the cardiovascular health program of the Centers for Disease Control and Prevention (CDC) in Atlanta.

"Over the past 30 to 50 years, CHD mortality has declined dramatically, but it seemed that the decline was slower in African Americans than in whites," says Zheng. "Our results confirm this. The reasons for the slower decline are not clear but could be attributed to more incidence of CHD in African Americans or to differences in medical care received by African Americans and whites."

The findings point toward a need for prevention programs tailored to the education, ethnicity and other characteristics of populations at increased risk for CHD, he says.

Researchers analyzed mortality data from U.S. Vital Statistics from 1979 to 1998. The black/white ratio for CHD mortality was used as a marker of racial disparity in deaths due to coronary disease. The 'black/white ratio' is a measure of CHD mortality in blacks in relation to whites (rate in blacks divided by rate in whites). A ratio of less than 1.00 reflected lower risk in African Americans, and a ratio greater than 1.00 reflected higher risk.

In 1979 the black/white ratio of CHD mortality in men was 0.77, but by 1998 the ratio had climbed 25 percent to 0.96. Among women the ratio was 0.93 in 1979 but rose 23 percent to 1.14 in 1998, indicating that the decrease in CHD mortality in black women had fallen behind that of white women.

Zheng emphasized that the increase in the ratio does not reflect an increase in the CHD death rate among African Americans but rather a slower decline in mortality compared to whites. Overall, CHD mortality declined by 33.3 percent in black men between 1979 and 1998, compared to 46.1 percent in white men. At the same time CHD mortality decreased by 26.5 percent in black women compared to 40.1 percent in white women.

The racial disparity widened and narrowed as a result of different patterns of CHD mortality in various age groups. In younger age groups, the disparity either increased or remained unchanged between 1979 and 1998.

The ratio of black to white female death rates dropped 9.2 percent for women age 35 to 44 between 1979 and 1998, yet black women still showed risk 146 percent higher than white women in 1998. The death rate ratio increased between 2 percent and 34 percent for other age brackets between 45 and over 85 in that time span. The female black/white ratio exceeded 1.00 in 1998 for all but the over 85 age group.

"Among the four race-gender groups we studied, black women had the slowest decline in CHD death rate over the period of time," says Zheng. "The reason for that is unclear. It may be related to a higher prevalence of cardiovascular disease risk factors, a lower rate of awareness of risk factors, reduced access to medical care or other issues."

In men ages 35 to 44, the ratio dipped by 2.8 percent, yet black men in this group still showed risk 40 percent higher than white men. In other age groups, the ratio of black to white death rates increased 21 percent to 35 percent.

"The difference in CHD mortality rates between blacks and whites aged 65 years and older decreased, indicating that the increase in risk of CHD death with age is now more alike between these groups. It will be important to understand the reasons for this change in order to mount more effective preventive programs," notes Zheng.

"CDC and our partners, including the American Heart Association, the Centers for Medicare and Medicaid Services, and the National Heart, Lung, and Blood Institute remain fully committed to accelerating the decline in heart disease deaths among African Americans," said George Mensah, MD, director of the CDC's cardiovascular health program and one of the co-authors. "Through coordinated media campaigns, support for local policies that promote heart-healthy behaviors, and greater sharing of our respective expertise and resources, we will work to eliminate this gap."
-end-
Other co-authors are: Janet B. Croft, Ph.D.; Darwin Labarthe, M.D., Ph.D., and Janice E. Williams, Ph.D., MPH.

CONTACT:
For information November 10 - 14, call: Carole Bullock or Bridgette McNeill at the Hilton Anaheim Hotel
(714) 251-5801

Abstract 3700

NR01-1353 (SS2001/Zheng)

American Heart Association

Related Coronary Heart Disease Articles from Brightsurf:

Women with coronary artery wall thickness at risk for heart disease
The thickness of the coronary artery wall as measured by MRI is an independent marker for heart disease in women, according to a new study.

E-cigarettes linked to heart attacks, coronary artery disease and depression
Concerns about the addictive nature of e-cigarettes -- now used by an estimated 1 out of 20 Americans -- may only be part of the evolving public health story surrounding their use, according to data being presented at the American College of Cardiology's 68th Annual Scientific Session.

Coronary calcium levels a better predictor of patients at risk for coronary heart disease
A new study presented at the American Heart Association Scientific Session conference found that testing a patient's coronary calcium levels is a better predictor of blocked coronary arteries at risk for a heart attack and the need for revascularization than standard risk-assessment equations used in medical practice today.

Coronary heart disease: DMP could be extended by two topics
Almost all health care aspects need to be updated. The already third search update for guidelines shows that their number and quality have increased notably in 10 years.

Learning about coronary heart disease from women
While many risk factors of CHD, such as smoking, high blood pressure and age, are common among men and women, some metabolic risk factors, such as being diabetic, are more strongly associated with increased risk of CHD in women than in men.

Cardiorespiratory fitness is essential to reduce risk of coronary heart disease
Coronary heart disease (CHD) is a leading cause of death for men in the US.

New study highlights smoking intensity in coronary heart disease risk
Increased relative risks for coronary heart disease (CHD) have long been associated with smoking, and traditionally they have been dependent on the number of cigarettes smoked a day, smoking intensities, and total exposure over time.

Pessimism associated with risk of death from coronary heart disease
Pessimism seems to be a strong risk factor for death from coronary heart disease, while optimism does not protect from it, according to a study published in the open-access journal BMC Public Health that involved 2,267 middle-aged and older Finnish men and women.

Study finds large decrease in coronary heart disease in US
The incidence of coronary heart disease in the US declined nearly 20 percent from 1983 to 2011, according to a study appearing in the Nov.

Americans are getting heart-healthier: Coronary heart disease decreasing in the US
Coronary heart disease is one of the leading causes of death in the United States.

Read More: Coronary Heart Disease News and Coronary Heart Disease Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.