Race/Ethnic and Sex Differences in the Association of Atherosclerotic Cardiovascular Disease Risk and Healthy Lifestyle Behaviors

Abstract

BackgroundLifestyle behaviors influence atherosclerotic cardiovascular disease (ASCVD) risk. We examined race and sex differences in the association of ASCVD risk with obesity and lifestyle behaviors.Methods and ResultsWe used multivariable logistic regression to examine the association of race/ethnicity and sex with obesity and lifestyle behaviors among 12 351 adults in the National Health and Nutrition Examination Surveys cycles 2005 to 2014. Ten‐year ASCVD risk was estimated using the 2013 American College of Cardiology/American Heart Association pooled cohort equations. Among overweight/obese subjects, whites were more likely to consider themselves overweight, to report a desire to weigh less, and to report a healthy diet, and physical activity. Despite higher body mass index and/or ASCVD risk, black women (adj odds ratio [OR] 0.8, 95% confidence interval [CI], 0.7–0.9) were less likely to attempt weight loss, and Hispanic women (OR 0.8, 95% CI 0.6–0.9) were less likely to report physical activity than white women. Black women (adj OR 0.6, 95% CI 0.5–0.7) were less likely than white women, and Hispanics (women adj OR 0. 6, 95% CI 0.5–0.7; men adj OR 0.7, 95% CI 0.6–0.9) were less likely than whites to report a healthy diet. Among those with ASCVD risk >7.5%, there were even greater disparities in the likelihood of healthy diet between black and Hispanic versus white women, and among Hispanic versus white men.ConclusionsRace/ethnic minorities are less likely to engage in healthy lifestyle behaviors despite higher body mass index and ASCVD risk. These findings underscore the need for culturally sensitive recommendations to improve cardiovascular outcomes in high‐risk populations, particularly minority women.

Interactive Effects of Racial Identity and Repetitive Head Impacts on Cognitive Function, Structural MRI-Derived Volumetric Measures, and Cerebrospinal Fluid Tau and Aβ

“…A recent study also reported decreased CSF t-tau and p-tau 181 in Blacks compared to Whites (Morris et al, 2019). These racial neurological disparities have been attributed to the association of Black racial identity with lifestyle behaviors across the life course known to influence cognitive aging (e.g., poor diet, sedentary behaviors) (Morris et al, 2018), cardiovascular disease (CVD) (Newman et al, 2005;Jackson et al, 2013;Benjamin et al, 2019), genetics (e.g., APOEε4 or ABCA7 status) (Reitz et al, 2013;Graff-Radford et al, 2016;Rajan et al, 2019), socioeconomic status (Zahodne et al, 2017), and other factors (Barnes and Bennett, 2014;Zahodne et al, 2017;Brewster et al, 2018). Many of these factors associated with racial identity may influence both clinical and neuropathological outcomes, whereas others (e.g., socioeconomic status) might have more specific impact on clinical function (e.g., neuropsychological test scores, dementia risk).…”

“…Autopsy studies also link Black racial identity with increased risk for neuropathologic changes of AD and related diseases, including cerebrovascular disease (Graff-Radford et al, 2016;Filshtein et al, 2019). Although, some studies have failed to find an association between Black racial identity and AD pathologic changes (Riudavets et al, 2006;Wilkins et al, 2006;Morris et al, 2018) and risk for dementia (Fillenbaum et al, 1998). A recent study also reported decreased CSF t-tau and p-tau 181 in Blacks compared to Whites (Morris et al, 2019).…”

Association between atherosclerotic cardiovascular diseases risk and renal outcome in patients with type 2 diabetes mellitus

“…1). Compared with excluded patients, included patients had longer duration of DM(96 vs 84 About 75.2% patients were at high risk of 10-year ASCVD event, which was defined as 10-year ASCVD risk ≥ 7.5% [19]. Among group CKD1, 2, 3 and 4 stage, 27.6%, 22.2%, 28.2% and 15.4% patients had 10-year ASCVD risk ≥ 7.5% respectively.…”

Management of cardiovascular diseases in HIV/AIDS patients

“…54 A survey conducted to assess the 10-year risk of atherosclerotic CVD noted the highest risk in Black and Hispanic groups compared to other ethnic and racial groups. 55 The high rates of immune suppression in these groups predispose them to an increased inflammatory risk and CVD. 31…”