Abstract 029: Racial Disparities in Coronary Heart Disease Mortality in the Regards Study
Background: Coronary heart disease (CHD) mortality has long been higher among US blacks compared with whites, especially among younger individuals. Recent progress on eliminating these disparities has not been reported.
Methods: We examined CHD mortality in the REGARDS study, a 30,239-member national prospective cohort study that oversampled blacks (41%) and residents of the southeastern US, recruiting from 2003-7. Baseline data included interviews and in-home collection of physiologic and medication data. Telephone follow-up was conducted every 6 months to detect endpoints, triggering medical record retrieval and expert adjudication. Deaths prompted interviews with next-of-kin or proxies, collection of medical records and death certificates. We examined risks for definite or probable CHD mortality overall, and separately for in-hospital and out-of-hospital CHD death. Cox models stratified on age 65 estimated hazard ratios (HR) for CHD mortality for blacks compared with whites, adjusting for sociodemographics and CHD risk factors.
Results: We analyzed 14,992 participants <65 years of age (44% blacks) and 14,678 >65 years of age (38% blacks). There were 126 CHD deaths among those age <65 and 273 among those age >65 over a mean follow-up of 4.2+1.5 SD years. Adjusting for age and region of residence, excess risks among blacks were generally more pronounced for those age <65, but this excess risk attenuated after adding all risk factors, except for in-hospital mortality for those >65 years of age (Table).
Conclusions: Risks for CHD mortality were higher among blacks, largely attributable to higher risk factor burden especially among the young, suggesting that targeted intervention efforts are needed to overcome this disparity. The excess risk for in-hospital mortality among older blacks warrants further attention.
- © 2013 by American Heart Association, Inc.