Abstract P089: Early CVD Events by Race and Sex: Does Risk for Atherothrombotic- and Hypertension-related Events Differ by Race and Sex? The Coronary Artery Risk Development in Young Adults (CARDIA) Study
African Americans (AA), both men (M) and women (W), have higher CVD mortality rates than European Americans (E), but AAM have lower prevalence of coronary calcified plaque than WM. AAs also have higher blood pressure (BP) and HDL-C than W; HDL-C is lower in M than W. We tested the hypotheses that AA race is related to higher risk of hypertension (HTN)-related events, and being male is related to higher risk of atherothrombotic (ATH)-related events, placing AAM at particularly high risk for CVD.
Methods: We used baseline risk factor data, and adjudicated events through 28 years of follow-up from the CARDIA study which recruited 5,115 participants aged 18-30 years at baseline (1985-6). ATH-related events included acute coronary syndrome with or without MI, coronary revascularization, and CHD and other atherosclerosis death. HTN-related events included heart failure, end-stage renal disease (ESRD), stroke, and death due to cardiomyopathy. CVD events excluded ESRD and included peripheral artery disease procedures. We analyzed time to first event censoring at death without incident CVD and at follow-up end. We built adjusted Cox models with forward selection including race, sex, age, education, and smoking status as forced predictors and selecting among physical activity, anthropometry, glycemia, lipid, and blood pressure risk factors.
Results: In unadjusted analyses, risk of HTN-related events was related to race (p<0.01) but not sex (p=0.35), ATH-related events to sex (P<0.01) but not race (p=0.44), and CVD events to race (p<0.01) and sex (P<0.01). Unadjusted, all risk factors were associated with both HTN- and ATH-related events, except physical activity was not related to ATH and CVD events. After adjustment (table), AAM had higher risk of HTN- and ATH-related events, EM had higher risk of ATH-related events, AAW had higher risk of HTN-related events, and all had higher risk of CVD events than EW.
Conclusion: Race and sex are differentially associated with early HTN- vs ATH-related events, and AAM were at increased risk for both.
Author Disclosures: C.E. Lewis: None. C.I. Kiefe: None. D.R. Jacobs: None. D.C. Goff: None. J.M. Shikany: None. S. Sidney: None. D. Duprez: None. D. Lloyd-Jones: None. J. Reis: None. P.J. Schreiner: None. R. Durant: None. Y. Kim: None. K. Kershaw: None.
- © 2017 by American Heart Association, Inc.