Poorer Blacks May Face Higher Odds of Heart Disease

For black women, study finds risk is doubled among those with lowest income

Wednesday, May 27, 2015

WEDNESDAY, May 27, 2015 (HealthDay News) -- Poorer black people under age 50 are more than three times as likely to have a heart attack, stroke or other cardiovascular ailment as black people with the highest wealth, a new study suggests.

Analyzing data from more than 5,300 black Americans, researchers also found that black women in the lowest income group had more than twice the risk of experiencing a cardiovascular "event" -- including death -- than those in the highest income group.

Study author Samson Gebreab, a staff scientist at the U.S. National Human Genome Research Institute, said the findings -- which could be fueled by a combination of physical and social factors -- emphasize the need for greater awareness of cardiovascular disease among blacks.

"We [also] think resources should be put into early detection and screening of cardiovascular disease, especially in African-American women and younger African-Americans," Gebreab said.

However, it's important to note that while this study found an association between income levels and heart health, it wasn't designed to prove a cause-and-effect relationship.

The study was published online May 27 in the Journal of the American Heart Association.

One in every four deaths in the United States is caused by heart disease, which is the leading cause of death for both men and women, according to the U.S. Centers for Disease Control and Prevention.

But the cardiovascular disease burden is even higher among blacks, according to the American Heart Association (AHA). Nearly half of all black adults have some form of cardiovascular disease, and they are twice as likely as whites to suffer a first stroke, the AHA reports.

Gebreab and his team used data from the Jackson Heart Study, which included black participants aged 21 to 94. The study followed the volunteers for an average of seven years. In that time, 362 new or repeated cardiovascular "events" -- or problems -- were recorded in the study group.

Participants' socioeconomic status was assessed in both adulthood and childhood. The researchers looked at factors such as income, education, wealth and public assistance. After adjusting results to account for age, smoking, weight, exercise levels and other chronic health conditions, wealth remained a significant predictor of cardiovascular events in women.

Family income during childhood wasn't linked to later-life cardiovascular risks, according to the study.

Being a black person aged 50 or younger or a black woman of any age were independent risk factors for cardiovascular disease, the study found. Wealth alone proved to be an independent cardiovascular disease risk factor in women, with those in the lowest one-third of wealth 68 percent more likely to have a cardiovascular event than those in the top one-third.

Black people generally have less access to health care and are less likely to undergo routine checkups and screenings, Gebreab said. These differences could influence the results. But higher levels of obesity and other cardiovascular risk factors, including high blood pressure, could also play a role, he suggested.

Dr. William Weintraub, chair of cardiology at Christiana Care Health System in Wilmington, Del., said the new study "confirms a lot of other very difficult and sad data." Weintraub was not involved in the research.

"African-Americans, traditionally in this society, remain disadvantaged in multiple ways," he said. "Over the course of a life span, there are disparities that lead to disparities in health."

Weintraub and Gebreab agreed that effectively tackling the issue would require efforts on many levels, including educationally, politically and socially.

"The health care system, by itself, is not going to take care of the problem," Weintraub said. "I think it's one of the most important challenges in our society."

SOURCES: Samson Gebreab, Ph.D., M.Sc., staff scientist, National Human Genome Research Institute, Bethesda, Md.; William Weintraub, M.D., chair of cardiology and Center for Outcomes Research, Christiana Care Health System, Wilmington, Del.; May 27, 2015, Journal of the American Heart Association, online

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