Blacks, women face greater burden from CVD risk factors

The impact of major cardiovascular risk factors combined is greater in women than men and in blacks than whites. While the gender gap may be narrowing, differences by race may be increasing, according to new research in the American Heart Association journal Circulation.

"We've been targeting traditional risk factors in public health campaigns for many years," said Susan Cheng, M.D., M.P.H., study lead author and Assistant Professor of Medicine at Brigham and Women's Hospital in Boston, Mass. "We wanted to take a look at how well we've been doing over time at keeping these risk factors from causing heart and vascular disease—both by preventing the risks from occurring and by minimizing their effects when they do occur."

Researchers studied population attributable risk (PAR) changes for the five major modifiable , smoking, , obesity, and diabetes. The PAR is a measure that considers how common a risk factor is and by how much the factor raises the chance of future cardiovascular disease.

Researchers examined data on 13,541 people (56 percent women, 26 percent black) in the Atherosclerosis Risk in Communities study. Participants attended examinations during four periods (1987-89, 1990-92, 1993-95 or 1996-98) when they were 52-66 years old and free of cardiovascular disease. Researchers assessed risk factors at these exams and then calculated the contribution of each factor to the risk of developing cardiovascular disease over the next 10 years.

Among their findings:

  • The combined PAR for the five major risk factors stayed the same in blacks while falling in whites (remaining at .67 in blacks, while changing from .56 to .48 in whites).
  • The contribution of diabetes to cardiovascular disease is higher in women than men (most recently.21 versus .14), and more than twice as high in blacks than whites (most recently.28 versus .13).
  • The contribution of high blood pressure to cardiovascular disease is higher in women than men (most recently.32 versus .19), and higher in blacks than whites (most recently .36 versus .21).
  • The contribution of obesity to has stayed at the same level over time (remaining at .06). Researchers emphasize that, despite comparably lower PAR values, the importance of obesity as a risk factor may be seen in later years and could be through its mediating effect on diabetes.
  • The contribution of smoking and high cholesterol has appeared to fall in recent years (changing from .15 to .13 for smoking, and from .18 to .09 for high cholesterol).

"Our results don't suggest that a risk factor like smoking has become any less dangerous, but that fewer people are smoking," Cheng said. "In fact, for current smokers the risk of heart and vascular disease has actually gone up, possibly because remaining smokers tend to smoke more heavily or carry additional ."

Improvements in awareness and treatments for high cholesterol, such as dietary changes and statin therapy, likely account for the lessened impact of that risk factor, researchers said.

"As we know, statins not only treat cholesterol abnormalities but reduce inflammation and have other protective effects," Cheng said.

The study results highlight the ongoing need for targeted as well as population-based approaches to risk factor modification, despite progressive improvements in efforts to reduce the overall burden of risk for heart and vascular disease, researchers said.

Related Stories

Modifiable risk factors impact CVD mortality in T2DM

date Jul 14, 2014

(HealthDay)—Modifiable risk factors can be targeted for early and continued intervention to reduce the risk of adverse outcomes in patients with type 2 diabetes mellitus and cardiovascular disease, according ...

Recommended for you

A-fib recurrence common five years after ablation

date 13 hours ago

(HealthDay)—Most patients with atrial fibrillation (AF) and systolic heart failure who undergo ablation have AF recurrence at five years, according to a study published in the April issue of the Journal of ...

Applied physics helps decipher the causes of sudden death

date 17 hours ago

Sudden cardiac death accounts for approximately 10% of natural deaths, most of which are due to ventricular fibrillation. Each year, it causes 300,000 deaths in the United States and 20,000 in Spain. Researchers have demonstrated ...

Cognitive problems are common after cardiac arrest

date 17 hours ago

Half of all patients who survive a cardiac arrest experience problems with cognitive functions such as memory and attention. This has been shown by a major international study led from Lund University. Surprisingly, however, ...

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.