Abstract MP53: Racial Disparities in Predicted Cardiovascular Risk among Young Men and Women in the National Longitudinal Study of Adolescent Health (Add Health) Study
Background: We used data from a nationally representative sample of young adults to examine sex-specific disparities in global cardiovascular risk across racial/ethnic groups, which have not previously been examined.
Methods: Data were from National Longitudinal Study of Adolescent Health subjects who participated in wave 4 (2007-08) and who had valid weights and non-missing data (7270 women; 6499 men). Age, race/ethnicity, educational attainment, and cardiovascular disease (CVD) risk factors (body mass index, smoking status, diabetes, systolic blood pressure, and use of antihypertensive medication) were collected via an in-home exam. We calculated the 30-Year risk for hard CVD endpoints (coronary death, myocardial infarction, stroke) using a Framingham-based prediction model including data on age, sex, and CVD risk factors. Gender-specific differences in 30-year risk of CVD by race were calculated with weighted age- and education-adjusted linear models. Interactions between race/ethnicity and education were tested.
Results: Mean age was 28.9 ± 1.7 years; participants were 69% non-Hispanic white (NHW), 15% non-Hispanic black (NHB), 12% Hispanic (HIS), 3% Asian/Pacific-Islander (API), 1% Native American (NA). Average 30-year risk of CVD was 10.3 ± 7.4% in men and 4.3 ± 4.1% in women. Compared to NHW men, NA and NHB had higher (p-values<0.05) and HIS and API had similar (p-values>0.05) 30-year risk of CVD. API and HIS women had lower risk and NHB and NA women had higher risk (all p-values<=0.05), compared to NHW women. A significant race/ethnicity by education interaction was observed (p-value=0.01), with racial/ethnic differences in women greatly reduced at the highest education level (Figure).
Conclusion: Disparities in global CVD risk were observed for young men and women, though mostly attenuated among women with higher education level. Strategies to reduce disparities in CVD should start early in life, consider gender differences, and focus on educationally disadvantaged groups.
- © 2013 by American Heart Association, Inc.