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Risk of Fatal Coronary Heart Disease Higher Among Black Men and Women

Rate of fatal CHD doubled in blacks compared with whites (Nov. 5)

In an examination of the incidence of coronary heart disease (CHD) in the U.S. by race and sex, black men and women had twice the rate of fatal CHD compared with white men and women, and this increased risk was associated with a greater prevalence of CHD risk factors, according to a study that will appear in the November 7 issue of JAMA. The study is being released early online to coincide with the American Heart Association’s Scientific Sessions.

Researchers conducted a study to examine racial and sex differences in incident total CHD, fatal CHD, and nonfatal CHD across race–sex groups. The study included 24,443 participants without CHD at the beginning of the study from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort, who resided in the continental U.S. and were enrolled between 2003 and 2007, with follow-up through December 2009. Blacks and whites had a similar average age, but smoking, diabetes, and reduced estimated glomerular filtration rate (a measure of kidney function) were more prevalent, and systolic blood pressure and the body mass index were higher, among blacks than whites.

The average follow-up period was 4.2 years. There were 659 total incident CHD events through December 2009, including 153 events in black men, 254 in white men, 138 in black women, and 114 in white women. The researchers found that although the measured incidence rate of total CHD was similar among black men and white men, black men had a higher incidence of fatal CHD and a lower incidence of nonfatal CHD. Women had lower incidence rates than men within each racial group. However, black women had higher incidence rates for total CHD, for fatal CHD, and for nonfatal CHD, compared with white women. The increased risk of fatal CHD among blacks was associated with a higher prevalence of cardiovascular disease risk factors.

“Excess risk factor burden among black men and women continues to be a major public health challenge, along with their high risk for death as the presentation of CHD. Increased emphasis on optimizing well-established CHD risk factors among blacks could potentially reduce these disparities,” the authors concluded.

Source: JAMA; November 5, 2012.

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