Prevention efforts needed to address causes of cardiovascular disease in African Americans in Minnesota, says study

Minnesota has the lowest age-adjusted heart disease mortality in the U.S.; yet, African American adults 35 to 63 have nearly double the rate of death from cardiovascular disease, compared to their white counterparts.

Study findings show that basic health beliefs and demographics, such as age, sex, marital status and level of education attained, were associated with the risk factors for cardiovascular disease. Of the study group, the prevalence of common risk factors were hypertension, 68%; hyperlipidemia, 47%; diabetes, 34%; and current cigarette smoking, 25%. Also, 18% of participants had cardiovascular disease, and the pervasiveness increased by 30% or greater with three or more risk factors.

"The increased risk factors and prevalence of cardiovascular disease stands out because our findings are significantly higher than found in previously documented studies," says LaPrincess Brewer, M.D., a preventive cardiologist at Mayo Clinic. Dr. Brewer is senior author of the study.

In comparison to Minnesota Heart Health Program findings, the Minnesota Heart Survey recorded only a 4% proportion of cardiovascular disease and the Atherosclerosis Risk in Community study found 13%. The incidence of common cardiovascular disease risk factors varied widely across similar studies, as well. Compared to those in the Minnesota Heart Health Program study, the Minnesota Heart Survey and the Jackson Heart Study, respectively, showed lower prevalence of:

• Hypertension, 29% and 63%, respectively.
• Hyperlipidemia, 29% and 33%, respectively.
• Diabetes, 5% and 19%, respectively.
• Smoking, 17% and 13%, respectively.

Regarding health beliefs, 99% of all participants agreed that their actions could affect health and cardiovascular disease prevention was important to them. Also, 83% reported trust in their health care provider and 39% had a perception that their risk of a cardiovascular event was high.

"The higher prevalence of risk factors and the corresponding burden of cardiovascular disease in African Americans in Minnesota are stark, but I am encouraged by the high level of trust in clinicians that this analysis revealed. Our community-based research FAITH Program (FAITH stands for Fostering African American Improvement in Total Health) will use these findings to continue working to improve cardiovascular disease risk factors in this population in community and clinical settings," says Dr. Brewer.

To better understand what drives these poor outcomes, researchers conducted a cross-sectional analysis of African Americans in Minnesota. Participants were already enrolled in the Minnesota Heart Health Program: Ask About Aspirin study and self-reported their answers through a questionnaire.

Using data gathered between May and December 2019, researchers examined the association between participants' characteristics, and age- and sex-adjusted cardiovascular disease risk factors. More than half of the 644 people sampled were women, and the mean age was 61 years.

This research was conducted in collaboration with researchers and community members from the University of Minnesota, Hue-Man Partnership and the Johns Hopkins School of Medicine.