Abstract P084: Cardiovascular Disease Burden in African Americans: The Jackson Heart Study

Abstract

Background: African Americans (AA) bear an excess burden of CVD compared to Whites. This burden persists when socioeconomic status (SES) and other known CVD risk factors are considered. One limitation to studies of Black-White disparities in CVD is that population subgroups with lower SES may be over-represented among AA compared to Whites. We aimed to quantify CVD burden in the Jackson Heart Study (JHS), an exclusively AA cohort with a balanced representation of SES. Methods: Baseline distributions of SES indicators in 5,301 JHS participants were compared to the US 2000 Census data. Baseline prevalence of myocardial infarction (MI), stroke and hypertension were compared to the National Health and Nutrition Examination Survey (NHANES) data collected during a comparable time period as the JHS baseline exam (2000-2004) (population reference including all races). Indirect standardization methods based on population age and sex specific prevalence were used to calculate the expected prevalence of MI, stroke and hypertension in the JHS. Standardized prevalence ratios (SPR) was calculated by dividing the observed by the expected prevalence. An SPR greater than 1 indicates excess burden. Results: Compared to national data, JHS participants were more likely to have some college education (61% vs. 52%) or a bachelor’s degree (32% vs. 24%), were more likely to hold management or professional occupations (36% vs. 34%), but had somewhat lower income, which could be in part due to a higher proportion (64%) of women in the JHS cohort. The observed baseline prevalence of MI, stroke and hypertension in JHS was 5.5%, 4.4% and 60.1%. The SPR for MI, stroke and hypertension were 1.05 (95% CI 0.88, 1.25), 1.39 (95% CI 1.12, 1.69) and 1.51 (1.42, 1.60) for men. The corresponding values for women were 1.61 (95% CI 1.37, 1.89), 1.33 (95% CI 1.12, 1.57) and 1.43 (95% CI 1.37, 1.50). Further analyses evaluating CVD risk factors (smoking, weight, physical activity, serum cholesterol, blood pressure and diabetes) found excess burden in overweight/obesity, physical inactivity, elevated blood pressure (≥140/90 mmHg), and diabetes among JHS participants compared to the population reference. Conclusions: We found an excess burden for stroke and hypertension in men, and an excess burden for MI, stroke and hypertension in women in the JHS. We also found an excess burden for CVD risk factors in the JHS cohort. Despite comparable SES between JHS and US population, we found an excess burden of CVD and CVD risk factors in this AA cohort.