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Distributions of Subclinical Cardiovascular Disease in a Socioeconomically and Racially Diverse Sample.

ABSTRACT: Differential subgroup vulnerability to subclinical cardiovascular disease is likely, and yet few, if any, studies have addressed interactive relations of age, sex, race, and socioeconomic status (SES) to these conditions to examine nuances of known health disparities. We examined distributions of carotid atherosclerosis and arterial stiffness in a socioeconomically diverse, biracial, urban sample.Participants (n=2270) in the population-based HANDLS study (Healthy Aging in Neighborhoods of Diversity Across the Life Span; 30-64 years old, 44% men, 57% African American, 39% with household income <125% federal poverty threshold) underwent carotid intimal medial thickness (IMT) and pulse wave velocity assessment.In cross-sectional hierarchical regression analyses, interactive race×SES effects were identified for IMT and pulse wave velocity, such that high SES African Americans had significantly thicker IMTs and faster pulse wave velocities than all other subgroups (ie, low SES African Americans, low SES whites, and high SES whites). A race×sex effect was also identified for IMT, such that the IMT discrepancy between white men and women was more pronounced than the discrepancy between African American men and women. Finally, an SES×sex effect indicated that while IMTs of high SES and low SES men did not significantly differ, high SES women had marginally thicker IMTs than low SES women.High SES African Americans may be particularly vulnerable to subclinical cardiovascular diseases, placing them at enhanced risk for clinical cardiovascular diseases, including stroke. These findings suggest that male sex, low SES, and African American ancestry may represent imprecise generalizations as risk factors for subclinical cardiovascular disease.

SUBMITTER: Wendell CR

PROVIDER: S-EPMC5373954 | biostudies-literature | 2017 Apr

REPOSITORIES: biostudies-literature

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Distributions of Subclinical Cardiovascular Disease in a Socioeconomically and Racially Diverse Sample.

Wendell Carrington R CR Waldstein Shari R SR Evans Michele K MK Zonderman Alan B AB

Stroke 20170224 4

<h4>Background and purpose</h4>Differential subgroup vulnerability to subclinical cardiovascular disease is likely, and yet few, if any, studies have addressed interactive relations of age, sex, race, and socioeconomic status (SES) to these conditions to examine nuances of known health disparities. We examined distributions of carotid atherosclerosis and arterial stiffness in a socioeconomically diverse, biracial, urban sample.<h4>Methods</h4>Participants (n=2270) in the population-based HANDLS ...[more]

PMID: 28235961

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Project description:ImportancePreeclampsia is an independent risk factor for future cardiovascular disease and disproportionally affects non-Hispanic Black women. The association of maternal nativity and duration of US residence with preeclampsia and other cardiovascular risk factors is well described among non-Hispanic Black women but not among women of other racial and ethnic groups.ObjectiveTo examine differences in cardiovascular risk factors and preeclampsia prevalence by race and ethnicity, nativity, and duration of US residence among Hispanic, non-Hispanic Black, and non-Hispanic White women.Design, setting, and participantsThis cross-sectional analysis of the Boston Birth Cohort included a racially diverse cohort of women who had singleton deliveries at the Boston Medical Center from October 1, 1998, to February 15, 2016. Participants self-identified as Hispanic, non-Hispanic Black, or non-Hispanic White. Data were analyzed from March 1 to March 31, 2021.ExposuresMaternal nativity and duration of US residence (<10 vs ≥10 years) were self-reported.Main outcome and measuresDiagnosis of preeclampsia, the outcome of interest, was retrieved from maternal medical records.ResultsA total of 6096 women (2400 Hispanic, 2699 non-Hispanic Black, and 997 non-Hispanic White) with a mean (SD) age of 27.5 (6.3) years were included in the study sample. Compared with Hispanic and non-Hispanic White women, non-Hispanic Black women had the highest prevalence of chronic hypertension (204 of 2699 [7.5%] vs 65 of 2400 [2.7%] and 28 of 997 [2.8%], respectively), obesity (658 of 2699 [24.4%] vs 380 of 2400 [15.8%] and 152 of 997 [15.2%], respectively), and preeclampsia (297 of 2699 [11.0%] vs 212 of 2400 [8.8%] and 71 of 997 [7.1%], respectively). Compared with their counterparts born outside the US, US-born women in all 3 racial and ethnic groups had a significantly higher prevalence of obesity (Hispanic women, 132 of 556 [23.7%] vs 248 of 1844 [13.4%]; non-Hispanic Black women, 444 of 1607 [27.6%] vs 214 of 1092 [19.6%]; non-Hispanic White women, 132 of 776 [17.0%] vs 20 of 221 [9.0%]), smoking (Hispanic women, 98 of 556 [17.6%] vs 30 of 1844 [1.6%]; non-Hispanic Black women, 330 of 1607 [20.5%] vs 53 of 1092 [4.9%]; non-Hispanic White women, 382 of 776 [49.2%] vs 42 of 221 [19.0%]), and severe stress (Hispanic women, 76 of 556 [13.7%] vs 85 of 1844 [4.6%]; non-Hispanic Black women, 231 of 1607 [14.4%] vs 120 of 1092 [11.0%]; non-Hispanic White women, 164 of 776 [21.1%] vs 26 of 221 [11.8%]). After adjusting for sociodemographic and cardiovascular risk factors, birth status outside the US (adjusted odds ratio [aOR], 0.74 [95% CI, 0.55-1.00]) and shorter duration of US residence (aOR, 0.62 [95% CI, 0.41-0.93]) were associated with lower odds of preeclampsia among non-Hispanic Black women. However, among Hispanic and non-Hispanic White women, maternal nativity (aOR for Hispanic women, 1.07 [95% CI, 0.72-1.60]; aOR for non-Hispanic White women, 0.98 [95% CI, 0.49-1.96]) and duration of US residence (aOR for Hispanic women <10 years, 1.04 [95% CI, 0.67-1.59]; aOR for non-Hispanic White women <10 years, 1.20 [95% CI, 0.48-3.02]) were not associated with preeclampsia.Conclusions and relevanceNativity-related disparities in preeclampsia persisted among non-Hispanic Black women but not among Hispanic and non-Hispanic White women after adjusting for sociodemographic and cardiovascular risk factors. Further research is needed to explore the interplay of factors contributing to nativity-related disparities in preeclampsia, particularly among non-Hispanic Black women.

Dataset Information

Distributions of Subclinical Cardiovascular Disease in a Socioeconomically and Racially Diverse Sample.

Publications

Distributions of Subclinical Cardiovascular Disease in a Socioeconomically and Racially Diverse Sample.

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