Comparability of risk factors for coronary heart disease among blacks and whites in the NHANES-I Epidemiologic Follow-up Study

Abstract

The incidence of new coronary events and the predictive strength of the major coronary risk factors were evaluated in a biracial sample drawn from the general U.S. population. In this cohort of 12,599 persons, free of reported coronary heart disease (CHD) at baseline, both hospitalizations and deaths coded to this cause were recorded prospectively. Based on CHD as the underlying cause of death, black men and women experienced higher age-adjusted mortality than their white counterparts (BM = 6.15, WM = 5.59, BW = 3.72 and WW = 2.58 [cumulative deaths, percent]), while having lower hospitalization rates than did whites. In a univariate logistic regression model, with all incident events as the endpoint, the predictive strength of the coronary risk factors was remarkably similar for the four sex-race groups. Notable exceptions included smoking, where the data from this study are problematic, and body mass index, where a relationship was noted only among white women. In a multivariate model, the beta coefficients were similar for age, systolic blood pressure, cholesterol, and income; the statistical significance varied among the groups. Within the power of this study to examine between-race differences, the predictive strength of the standard risk factors are very similar. None of the within-sex, between-race differences in the multivariate relationships were significant, although sizable percentage differences were noted. Blacks appeared to receive less hospital care for CHD, despite higher rates of fetal events.