Abstract 14124: Long-term Cardiovascular Mortality Disparities By Race In The Us Adult Population

Abstract

Cardiovascular disease remains the leading cause of mortality and disproportionately affects vulnerable populations. Among disparities in overall mortality, Black Americans experience higher mortality rates than White Americans. However, it is unknown, if the same disparities persist after long-term follow-up. In this study, we assessed the hypothesis that Non-Hispanic Black Americans experience higher 10-year cardiovascular disease (CVD) mortality follow-up than Non-Hispanic White Americans. We analyzed data on adults (≥ 20 years) from the 1999-2010 National Health and Nutrition Examination Survey, with mortality data obtained through 2015. The causes of death for adults (N=4037) were defined using the International Classification of Disease coding (ICD-10). Complex Samples Cox regression was used to assess if diabetes status modified the relationship between race and CVD-mortality. Out of the respondents (N=4037), 17.7% of Non-Hispanic Blacks individuals died from CVD versus 16.4% among Non-Hispanic White counterparts. During the 11-year follow-up, the hazard ratio (HR) for CVD-mortality among Non-Hispanic Black Adults, with adjustment for age and gender only, was 1.36; 95% confidence interval [CI: 1.11, 1.67]. Over the age of 20, there is higher CVD-mortality in Non-Hispanic Black men (HR, 1.15; 95% CI, 0.91–2.05, p > .05) and women (HR, 2.50; 95% CI, 1.56–3.99, p < .01) than in their White counterparts even after controlling for medical (obesity, CVD, diabetes) and demographic (education, age, food insecurity level, and poverty level) variables. In conclusion, Black Americans experience higher probability of death from cardiovascular disease in 10-year follow-up than other races. Due to the chronicity of CVD, disparities are compounded over a long period of time. The observed ethnic disparities in treatment and control, with the relative deficits observed in Black Americans, are potentially due to ethnic differences in healthcare-seeking behaviors and access to care. Policy considerations should address how to improve equitable screening and prevention, as it pertains to race.