© 1998 American Heart Association, Inc.
Original Contributions |
Differences in Prevalence of and Risk Factors for Subclinical Vascular Disease Among Black and White Participants in the Cardiovascular Health Study
From the University of Pittsburgh, Pa (L.K.); the Cardiovascular Health Study Coordinating Center, Seattle, Wash (L. Fisher, R.M.); Johns Hopkins University, Baltimore, Md (L. Fried); the University of Vermont, Burlington (M.C.); Bowman Gray School of Medicine, Winston-Salem, NC (S.J.); and the National Heart, Lung, and Blood Institute, Bethesda, Md (T.M.).
Correspondence to Lewis H. Kuller, MD, DrPH, University of Pittsburgh, Department of Epidemiology, GSPH, 130 DeSoto St, Pittsburgh, PA 15261. E-mail kuller+{at}pitt.edu
Abstract—A composite measure
of subclinical vascular disease has been developed in the
Cardiovascular Health Study (CHS). In previous reports,
we measured the prevalence of subclinical disease among the original
5201 participants in the CHS, the relationship of risk factors to
subclinical disease, and the association of subclinical disease to
clinical coronary heart disease. In 1992 to 1993 (year 4 of the
study), a larger cohort of 424 black women and 248 black men was added
to the study. In this study, we have compared the prevalence of
subclinical disease among blacks and whites in the CHS and the
association with cardiovascular risk factors. The
prevalence of subclinical disease for all participants (aged 
65
years) was 41.3% for white women, 39.7% for black women, 41.9% for
white men, and 43.7% for black men. The prevalence increased with age.
The risk factor associations for subclinical disease were similar among
blacks and whites. In multivariate analysis,
age, systolic blood pressure, LDL cholesterol,
smoking, and family history of myocardial infarction were independently
associated with subclinical disease among both black and white women,
while for white men, systolic blood pressure, use of
antihypertensive medication, smoking, body mass index, and
diastolic blood pressure (inverse) were related to
subclinical disease. In black men, blood triglyceride
level, use of antihypertensive medications, and family history of
myocardial infarction (inverse) were associated with subclinical
disease.
Key Words: cardiovascular disease • race • risk factors • subclinical disease
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