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Reasons for Differences in the Incidence of Venous Thromboembolism in Black Versus White Americans.

TitleReasons for Differences in the Incidence of Venous Thromboembolism in Black Versus White Americans.
Publication TypeJournal Article
Year of Publication2019
AuthorsFolsom AR, Basu S, Hong C-P, Heckbert SR, Lutsey PL, Rosamond WD
Secondary AuthorsCushman M
Corporate AuthorsAtherosclerosis Risk in Communities(ARIC) study
JournalAm J Med
Volume132
Issue8
Pagination970-976
Date Published2019 08
ISSN1555-7162
KeywordsAfrican Continental Ancestry Group, Continental Population Groups, European Continental Ancestry Group, Female, Humans, Incidence, Male, Middle Aged, Risk Factors, Socioeconomic Factors, United States, Venous Thromboembolism
Abstract

INTRODUCTION: Venous thromboembolism incidence rates are 30%-100% higher in US blacks than whites. We examined the degree to which differences in the frequencies of socioeconomic, lifestyle, medical risk factors, and genetic variants explain the excess venous thromboembolism risk in blacks and whether some risk factors are more strongly associated with venous thromboembolism in blacks compared with whites.

METHODS: We measured venous thromboembolism risk factors in black and white participants of the Atherosclerosis Risk in Communities study in 1987-1989 and followed them prospectively through 2015 for venous thromboembolism incidence.

RESULTS: Over a mean of 22 years, we identified 332 venous thromboembolisms in blacks and 578 in whites, yielding 65% higher crude incidence rates per 1000 person-years in blacks. The age and sex-adjusted hazard ratio (95% confidence interval) of venous thromboembolism for blacks compared with whites was 2.04 (1.76, 2.37) for follow-up >10 years and was attenuated to 1.14 (0.89, 1.46) when adjusted for baseline confounders or mediators of the race association, which tended to be more common in blacks. For example, adjustment for just baseline weight, family income, and concentration of plasma factor VIII reduced the regression coefficient for race by 75%. There were no significant (P

CONCLUSION: The higher incidence rate of venous thromboembolism in blacks than whites was mostly explained by blacks having higher frequencies of venous thromboembolism risk factors.

DOI10.1016/j.amjmed.2019.03.021
Alternate JournalAm J Med
PubMed ID30953632
PubMed Central IDPMC6744355
Grant ListR01 HL059367 / HL / NHLBI NIH HHS / United States
HHSN268201700002C / HL / NHLBI NIH HHS / United States
HHSN268201700001I / HL / NHLBI NIH HHS / United States
HHSN268201700004I / HL / NHLBI NIH HHS / United States
HHSN268201700004C / HL / NHLBI NIH HHS / United States
HHSN268201700003I / HL / NHLBI NIH HHS / United States
HHSN268201700005C / HL / NHLBI NIH HHS / United States
HHSN268201700001C / HL / NHLBI NIH HHS / United States
HHSN268201700003C / HL / NHLBI NIH HHS / United States
HHSN268201700002I / HL / NHLBI NIH HHS / United States
HHSN268201700005I / HL / NHLBI NIH HHS / United States