The association of race and socioeconomic status with cardiovascular disease indicators among older adults in the health, aging, and body composition study

Abstract

Objectives: We hypothesized that older Black adults would have a higher prevalence of cardiovascular disease (CVD) than White adults, as indicated by elevated systolic blood pressure (SBP), low ankle-arm blood pressure index (AAI), and left ventricular hypertrophy (LVH). But, accounting for a broad interpretation of socioeconomic status (SES) (i.e., education, family income, home ownership, and other assets) would reduce these differences.

Methods: Data are from the Health, Aging, and Body Composition study, a longitudinal clinical research study of 3,075 well-functioning adults aged 70-79, in which 46% of women and 33% of men are Black. Logistic regression modeled racial and SES differences in CVD indicators.

Results: Being Black was significantly associated with elevated SBP (men only), low AAI, and LVH, and remained significant after accounting for each SES measure. The racial association with CVD was reduced the most by income for elevated SBP in men, other assets for low AAI in women and men, and other assets for LVH in men.

Discussion: Contrary to the age-as-leveler theory, being Black was strongly associated with CVD indicators, and accounting for SES did not reduce this association. Whether other SES measures, such as access to care, could explain the racial association remains to be explored.