Comparison of Risk Factors for Cardiovascular Mortality in Black and White Adults

Carnethon, Mercedes R.; Lynch, Elizabeth B.; Dyer, Alan R.; Lloyd‐Jones, Donald M.; Wang, Renwei; Garside, Daniel B.; Greenland, Philip

doi:10.1001/archinte.166.11.1196

Cited by 45 publications

(27 citation statements)

References 28 publications

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“…Other health-related behaviors, including physical activity and nutrition, show similar differences in other populations. [17][18][19] Why socially disadvantaged populations are more likely to drink sugar-sweetened soda is not clear, but the low cost and marketing in convenience stores that are common in low-income New York City neighborhoods 20 may play a role. The fact that income-to-poverty ratio, educational attainment, and race/ethnicity/birthplace were all independent predictors of frequent soda consumption suggest that a combination of factors related to economic resources, health literacy, and culture may contribute to these differences.…”

Section: Factors Associated With Soda Consumption In New York City Admentioning

confidence: 99%

Demographic and Behavioral Factors Associated with Daily Sugar-sweetened Soda Consumption in New York City Adults

et al. 2008

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The objective of the study was to assess the relations of socioeconomic and behavioral factors to frequent consumption of sugar-sweetened soda among New York City (NYC) adults and the relation of frequent consumption to body mass index (BMI; kg/m 2 ). Data from the 2005 NYC Community Health Survey, a population-based telephone survey, were analyzed. Frequent consumption was defined as drinking one or more 12-oz servings of sugar-sweetened soda on an average day; 9,865 adults, aged 18 years and older, provided valid responses. Logistic regression was used to identify factors associated with frequent consumption, and linear regression models were used to assess the relation of frequent consumption to BMI. An estimated 27.5% of NYC adults are frequent sugar-sweetened soda consumers. Frequent consumption is independently associated with low household income (odds ratio [OR]=1.7, 95% confidence interval [CI] 1.4-2.1 for G200% vs. ≥600% federal poverty level) and with ethnic group and nativity (e.g., OR=3.1, 95% CI 2.6-3.7 for U.S.-born blacks vs. whites). Men report more consumption then women, but an association of less education with frequent consumption is stronger among women. Adjusting for demographics, frequent consumption is associated with more television viewing and with less physical activity. Adjusting for demographics and behaviors, frequent consumption was associated with higher BMI among women (0.7 BMI units, 95% CI 0.1-1.2) but not among men. Disparities in sugar-sweetened soda consumption mirror obesity disparities. Improved surveillance and interventions are needed to better quantify and reduce consumption of sugar-sweetened beverages, especially in groups most impacted by obesity.

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Section: Factors Associated With Soda Consumption In New York City Admentioning

confidence: 99%

Demographic and Behavioral Factors Associated with Daily Sugar-sweetened Soda Consumption in New York City Adults

et al. 2008

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“…Based on smoking data available for 336 workers who participated in screening conducted by ATSDR in Libby in 2000/2001, 6 we assumed that in the entire cohort, the proportion of smokers ranged 50% to 66% among the unexposed and 66% to 85% among the exposed. By using published ranges of the risks of lung cancer, NMRD and cardiovascular disease associated with smoking, [31][32][33] we used a Monte Carlo-approach in which we randomly sampled from distributions based on these parameters 10,000 times to obtain an RR adjusted for smoking. After adjustment, the RR for lung cancer was reduced from 2.4 to 2.0.…”

Section: Discussionmentioning

confidence: 99%

Vermiculite Worker Mortality: Estimated Effects of Occupational Exposure to Libby Amphibole

Larson

Antao

Bove

2010

Journal of Occupational &Amp; Environmental Medicine

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Objective: To examine the relationship between cumulative fiber exposure (CFE) and mortality in a retrospective cohort study of vermiculite workers exposed to Libby amphibole (n ϭ 1862). Methods: Extended Cox regression was used to estimate the hazards associated with CFE as a timedependent covariate of multiple-cause mortality. Results: The Cox models for mesothelioma, asbestosis, lung cancer, and non-malignant respiratory disease were significant with rate ratios that increased monotonically with CFE. The model for deaths due to cardiovascular disease was also significant (rate ratio for CFE Ն44.0 f/cc-y vs Ͻ1.4 f/cc-y was 1.5; 95% confidence interval ϭ 1.1 to 2.0). Conclusions: By using a within-cohort comparison, the results demonstrate a clear exposure-response relationship between CFE and mortality from asbestos-related causes. The finding of an association between CFE and cardiovascular mortality suggests persons exposed to Libby amphibole should be monitored for this outcome. L ibby, Montana was the site of a vermiculite mining and processing operation from the 1920s to 1990. Although vermiculite causes no known adverse health effects, Libby vermiculite is contaminated with a mixture of amphibole fibers. These amphiboles have been collectively called tremolite by the community, popular press, and in some scientific literature 1 but Libby vermiculite also contains actinolite 2 and unregulated asbestos-like fibers, including winchite and richterite. 1,3 The only chemical difference between these amphiboles is their iron content; this mineralogic difference is somewhat arbitrary and may have no biological significance. 2 Regardless, the raw vermiculite ore mined in Libby contained up to 26% amphibole fibers by mass. 4 Libby is thought have produced 80% of the world's supply of vermiculite during the 20th century. 5 Because many of its years of operation predated significant regulation of occupational asbestos exposure, the amphibole exposures at the Libby vermiculite operation were quite high, especially before engineering controls were put in place in the late 1960s and early 1970s. The resulting health effects of working at the Libby vermiculite operation have been well documented, demonstrating excesses of asbestos-related morbidity and mortality. 6 -8 An excess of asbestos-related mortality among Libby vermiculite workers is not surprising given their occupational amphibole exposures. In this study, we use mortality data on the entire vermiculite worker cohort updated through the end of 2006. Our objective was to conduct an exposure-response study to obtain estimates of the hazard of asbestos-related mortality associated with cumulative asbestos exposure.

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“…Could the higher prevalence of hypertension and T2DM among African Americans [8][9][10][11] be exerting such a dominant cardiotoxic effect as to override the benefits from favorable risk factors? The question of magnitude of individual risk factor effect on CVD mortality by race was investigated by Carnethon et al [35]. They report that by and large, most traditional risk factors exhibit similar associations with mortality across races [35].…”

Section: Do Unfavorable Risk Factors Exert Greater Influence Than Favmentioning

confidence: 99%

“…The question of magnitude of individual risk factor effect on CVD mortality by race was investigated by Carnethon et al [35]. They report that by and large, most traditional risk factors exhibit similar associations with mortality across races [35]. Thus, although attractive, the notion of ethnic disparity in the effect size of individual CVD risk factors remains speculative.…”

Section: Do Unfavorable Risk Factors Exert Greater Influence Than Favmentioning

confidence: 99%

Dissociation Between Cardiovascular Risk Markers and Clinical Outcomes in African Americans: Need for Greater Mechanistic Insight

Dagogo‐Jack

2011

Curr Cardiovasc Risk Rep

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Despite having distinct advantages, such as lower serum triglycerides, higher high-density lipoprotein (HDL) cholesterol levels, and less visceral adiposity, African Americans suffer disproportionately from cardiovascular disease (CVD). In African Americans, attention often focuses on two cardiometabolic risk factors-hypertension and type 2 diabetes mellitus-because they occur more frequently in African Americans than whites. Exactly how hypertension and hyperglycemia appear to override benefits from the lower prevalence of dyslipidemia and other factors is unknown. From a practical viewpoint, as the combined effects of hypertension and type 2 diabetes mellitus are dominant, then primary prevention with vigorous control of these conditions must be of utmost priority. However, because attention is focused on hypertension and type 2 diabetes mellitus, the role of other potential risk factors, such as low-density lipoprotein cholesterol oxidation, HDL cholesterol function, lipoxygenase pathway, endothelial progenitor cells, and natriuretic peptide regulation, have not been well studied. In this review, we discuss the paradox of CVD morbidity and mortality among African Americans and offer suggestions for future investigation.

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Comparison of Risk Factors for Cardiovascular Mortality in Black and White Adults

Abstract: Most traditional risk factors demonstrated similar associations with mortality in black and white adults of the same sex. Small differences were primarily in the strength, not the direction, of association.

Cited by 45 publications

References 28 publications

Demographic and Behavioral Factors Associated with Daily Sugar-sweetened Soda Consumption in New York City Adults

Demographic and Behavioral Factors Associated with Daily Sugar-sweetened Soda Consumption in New York City Adults

Vermiculite Worker Mortality: Estimated Effects of Occupational Exposure to Libby Amphibole

Dissociation Between Cardiovascular Risk Markers and Clinical Outcomes in African Americans: Need for Greater Mechanistic Insight

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