Black–White CVD disparities diminish with older age
MedWire News: Disparities in cardiovascular disease (CVD) prevalence and mortality between Black and White people typically emerge in young adulthood and disappear by old age, an analysis of US survey data suggests.
Accordingly, the study authors recommend that attempts by policy-makers and clinicians to reduce racial disparities should focus on young and middle-aged Black people.
Stacey Jolly (University of California San Francisco) and team used the Third National Health And Nutrition Examination Survey (NHANES) database to investigate racial differences in CVD. NHANES is a cross-sectional, nationally representative sample of adults.
Age-specific analyses revealed that Black-White disparities in CVD prevalence were most pronounced in people aged 35-44 years, declined with each successive decade, and disappeared among those aged 75 years and above.
A similar pattern was seen for each of the specific CVD diagnoses examined, namely, heart failure, stroke, and myocardial infarction. Traditional CVD risk factors, socioeconomic factors, and access to care were each found to contribute to racial disparities in prevalence.
After adjusting for all these factors, however, CVD prevalence remained significantly higher in Black versus White people among those aged 35-44 years.
The team then used the National Compressed Mortality File to determine age-specific CVD mortality rates. Again, they found that CVD mortality was higher in Blacks than Whites at younger ages but that this gap closed with advancing age.
Indeed, 28% of all CVD deaths in Blacks occurred in those aged <65 years compared with just 13% among Whites.
Writing in the American Journal of Medicine, Jolly et al conclude: "Our results highlight the importance of understanding the current epidemiology of disease patterns.
"Policy-makers, public health officials, and clinicians aimed at reducing health disparities should focus on the period when these Black-White CVD disparities appear to emerge, among those over age 35 years who are young to middle-aged."
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By Joanna Lyford