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Differences in Cardiovascular Mortality Risk among African Americans in the Minnesota Heart Survey: 1985-2015 vs The Atherosclerosis Risk in Communities Study Cohort: 1987-2015.

TitleDifferences in Cardiovascular Mortality Risk among African Americans in the Minnesota Heart Survey: 1985-2015 vs The Atherosclerosis Risk in Communities Study Cohort: 1987-2015.
Publication TypeJournal Article
Year of Publication2019
AuthorsGeorge KM, Folsom AR, Steffen LM, Wagenknecht LE
Secondary AuthorsMosley TH
JournalEthn Dis
Volume29
Issue1
Pagination47-52
Date Published2019 Winter
ISSN1049-510X
KeywordsAdult, African Americans, Aged, Atherosclerosis, Cardiovascular Diseases, Female, Follow-Up Studies, Forecasting, Humans, Incidence, Male, Middle Aged, Minnesota, North Carolina, Risk Assessment, Risk Factors, Survival Rate
Abstract

Geographic differences in cardiovascular disease (CVD) mortality among African Americans (AAs) are well-established, but not well-characterized. Using the Minnesota Heart Survey (MHS) and Atherosclerosis Risk in Communities (ARIC) Study, we aimed to assess whether CVD risk factors drive geographic disparities in CVD mortality among AAs. ARIC risk factors were measured between1987-1989 from a population-based sample of AAs, aged 45 to 64 years, living in Jackson, MS and Forsyth County, NC. Similar measures were made at MHS baseline, 1985, in AAs from Minneapolis-St. Paul, MN. CVD mortality was identified using ICD codes for underlying cause of death. We compared MHS and ARIC on CVD death rates using Poisson regression, risk factor prevalences, and hazard ratios using Cox regression. After CVD risk factor adjustment, AA men in MHS had 3.4 (95% CI: 2.1, 4.7) CVD deaths per 1000 person-years vs 9.9 (95% CI: 8.7, 11.1) in ARIC. AA women in MHS had 2.7 (95% CI: 1.8, 3.6) CVD deaths per 1000 person-years vs 6.7 (95% CI: 6.0, 7.4) in ARIC. A 2-fold higher CVD mortality rate remained in ARIC vs MHS after additional adjustment for education and income. ARIC had higher total cholesterol, hypertension, diabetes, and BMI, as well as less education and income than MHS. Risk factor hazard ratios of CVD death did not differ. The CVD death rate was lower in AAs in Minnesota (MHS) than AAs in the Southeast (ARIC). While our findings support maintaining low risk for CVD prevention, differences in CVD mortality reflect unidentified geographic variation.

DOI10.18865/ed.29.1.47
Alternate JournalEthn Dis
PubMed ID30713416
PubMed Central IDPMC6343542
Grant ListT32 HL007779 / HL / NHLBI NIH HHS / United States
HHSN268201700001I / HL / NHLBI NIH HHS / United States
HHSN268201700004I / HL / NHLBI NIH HHS / United States
HHSN268201700002I / HL / NHLBI NIH HHS / United States
HHSN268201700005I / HL / NHLBI NIH HHS / United States
HHSN268201700003I / HL / NHLBI NIH HHS / United States