Abstract

Introduction: Cardiovascular disease (CVD) is the leading cause of death in the U.S. Blacks are disproportionately affected by CVD risk factors, compared to whites. However, Blacks are not monolithic and include the following ethnic groups; African Americans (AAs), African Immigrants (AIs), and Afro-Caribbeans (ACs). It is unclear how AIs and ACs compare to their AA counterparts and Whites with respect to CVD risk factors. Objective: To examine trends in CVD risk factors among three Black ethnic groups in comparison to whites between 2010-2018. Methods: A comparative analysis of the National Health Interview Survey was conducted among N=452,997 participants, examining sociodemographic data and trends in self-reported CVD risk factors (hypertension, diabetes, overweight/obesity, and smoking). Generalized linear models with a Poisson distribution were used to obtain the respective predictive probabilities of CVD risk factors. Results: The sample included 82,835 Blacks (89% AAs, 5% AIs and 6% ACs) and 370,362 whites. AIs were the youngest with mean age of 40.8 years and were less likely to be insured (76%) compared to whites (91%) and AAs (83%) ( p =<0.001). ACs (23%) were more likely be college-educated than AAs (17%) but not AIs (36%) or whites (32%), (p=<0.001). AIs had the lowest age- and sex-adjusted prevalence of all four CVD risk factors. There were disparities (among AAs) and advantages (among AIs and ACs) in CVD risk factors. ( Figure) . Overweight/obesity and diabetes prevalence was increasing in AAs and whites ( p -values for trend<0.001). Smoking prevalence was highest in whites and AAs compared to AIs and ACs but the prevalence decreased significantly between 2010-2018 ( p -values for trend<0.001). Conclusion: Our results have shown significant heterogeneity in CVD risk factors among three Black ethnic groups compared to whites. These findings suggest that race alone does not account for health disparities in CVD risk factors. Environmental, psychological, and social factors may play a larger role in CVD risk.

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