To assess risk factors and incident cardiovascular disease, Susan Cheng, MD, MPH, of Brigham and Women’s Hospital in Boston, and colleagues analyzed data from 13,451 patients (56% female; 26% African American) in the Atherosclerosis Risk in Communities Study.
Patients (aged 52 to 55 years) were free of CVD at exams in 1987 through 1989, 1990 through 1992, 1993 through 1995, or 1996 through 1998. The population attributable risks (PAR) of traditional risk factors (hypertension, diabetes mellitus, obesity, hypercholesterolemia, and smoking) were established at each examination for the 10-year incidence of CVD.
The PAR of all risk factors combined appeared to decrease from the late 1980s to the late 1990s (0.58 to 0.53). In women, the combined PAR was higher compared with men in 1987 through 1989 (P<0.001) but not by the late 1990s (P=0.08).
Black patients had a combined PAR that was higher than white patients in the late 1980s (P=0.049), and this difference was more pronounced by the late 1990s (P=0.002). By the late 1990s, the PAR of hypertension and diabetes mellitus was higher in women than men (P=0.02 and P<0.0001, respectively), and both were also higher in blacks than whites (P=0.08 and P<0.0001, respectively).
“The contribution to CVD of all traditional risk factors combined is greater in blacks than whites, and this difference may be increasing,” wrote the researchers. “The contributions of hypertension and diabetes mellitus remain especially high, in women as well as blacks.”