Background: Although non-institutionalized black American and Latino adults exhibit a disproportionate burden of cardiovascular disease (CVD) compared to US whites, racial/ethnic disparities are not consistently observed among those incarcerated. Importantly, it is uncertain whether the burden of multiple cardiovascular conditions varies by race/ethnicity among incarcerated individuals. Hypothesis: We assessed the hypothesis that the burden of multiple CVD conditions would be higher among incarcerated non-Hispanic blacks (black) and Latinos compared to non-Hispanic whites (white). Methods: Data from a sample of 14,499 men and women (weighted N=689,161) from the 2004 Survey of Inmates in State Correctional Facilities, a nationally representative sample of adults incarcerated in state facilities, were analyzed. Computer-assisted personal interviews were utilized to collect information on medical history, demographic and socioeconomic factors, prison activities and various offense related factors. Race/ethnicity was defined as self-reported white, black, Spanish/Latino/Hispanic (Latino), or Other. Prior or current CVD conditions (hypertension, diabetes, BMI≥30 kg/m 2 , heart problems, or stroke) were obtained by self-report. Body mass index (BMI, kg/m 2 ) was based on self-reported height and weight. Three separate outcomes were defined based on the cumulative number of CVD conditions (≥1, ≥2 or ≥3 CVD conditions). Age-adjusted survey weighted multivariable logistic regression was used to estimate racial/ethnic disparities in the burden of CVD conditions separately by sex. Results: The median age was 34 years (IQR: 26-42) among men and 35 years (IQR: 27-41) among women. A history of ≥1 CVD condition was reported by 41% of men and 51% of women, while 26% of men and 37% of women reported ≥2 CVD conditions and 10% and 15% of men and women, respectively, reported ≥3. In age adjusted models, among women, significant racial/ethnic disparities were observed among both black and Latina women across all three definitions of CVD burden. The greatest disparities were observed among black women with ≥2 CVD conditions (OR=1.94, 95% CI: 1.62-2.33) followed by Latinas (OR=1.67, 95% CI: 1.32-2.13) compared to whites. Among men in age-adjusted analyses, black men exhibited a similarly greater odds of ≥2 or ≥3 CVD conditions (OR=1.31, 95% CI: 1.18-1.45 and OR=1.36, 95% CI: 1.17-1.57, respectively) compared to white men. Among Latino men compared to whites, modest disparities were only observed for ≥2 CVD conditions (OR=1.17, 95%CI: 1.03-1.33). Conclusions: Black and Latina women and black men exhibited a significantly greater burden of CVD conditions compared to white women and men, respectively. These data highlight the prominent racial/ethnic disparities among incarcerated populations of color and the need for tailored interventions to reduce cardiovascular risk in these populations.
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