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Mortality rates and risk factors for coronary disease in black as compared with white men and women.
N Engl J Med 1993; 329(2):73-8NEJM

Abstract

BACKGROUND

Currently recognized risk factors for coronary artery disease have been identified primarily from investigations of white populations. In this investigation, we estimated mortality rates for coronary disease and for any cause and identified risk factors for death from coronary disease among whites and blacks.

METHODS

Data collected over a 30-year period in the Charleston Heart Study were used to estimate mortality rates and quantify associations with risk factors assessed at the base-line examination in 1960 and 1961 of 653 white men, 333 black men, 741 white women, and 454 black women.

RESULTS

There were no significant racial differences in the rate ratios for death from coronary disease; however, women had significantly lower death rates than men. Over the 30-year period, the mortality rates for coronary disease per 1000 person-years were 5.2 for white men (95 percent confidence interval, 4.1 to 6.3), 4.6 for black men (3.0 to 6.2), 2.1 for white women (1.6 to 2.6), and 3.2 for black women (2.3 to 4.0). Significant, or nearly significant, predictors of mortality due to coronary disease were systolic blood pressure in all four groups; serum cholesterol level among white men, white women, and black women; and smoking among white men, white women, and black men. Although the difference was not statistically significant, the risk of death from coronary disease was consistently increased among diabetics in all four groups. A higher level of education was predictive of lower rates of death due to coronary disease among white men and black women. For all causes of death taken together, the rates for blacks were higher than the rates for whites. The presence of hypertension, a history of smoking, and a history of diabetes were significant or nearly significant predictors of mortality from any cause in all four groups.

CONCLUSIONS

Although the rates of death from coronary disease were somewhat lower among black men than white men and higher among black women than white women, the black:white mortality rate ratios were not statistically significant, and the major risk factors for mortality from coronary disease were similar in blacks and whites in the 30-year follow-up of the Charleston Heart Study.

Authors+Show Affiliations

Charleston Heart Study, Medical University of South Carolina 29425-2239.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

8510705

Citation

Keil, J E., et al. "Mortality Rates and Risk Factors for Coronary Disease in Black as Compared With White Men and Women." The New England Journal of Medicine, vol. 329, no. 2, 1993, pp. 73-8.
Keil JE, Sutherland SE, Knapp RG, et al. Mortality rates and risk factors for coronary disease in black as compared with white men and women. N Engl J Med. 1993;329(2):73-8.
Keil, J. E., Sutherland, S. E., Knapp, R. G., Lackland, D. T., Gazes, P. C., & Tyroler, H. A. (1993). Mortality rates and risk factors for coronary disease in black as compared with white men and women. The New England Journal of Medicine, 329(2), pp. 73-8.
Keil JE, et al. Mortality Rates and Risk Factors for Coronary Disease in Black as Compared With White Men and Women. N Engl J Med. 1993 Jul 8;329(2):73-8. PubMed PMID: 8510705.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mortality rates and risk factors for coronary disease in black as compared with white men and women. AU - Keil,J E, AU - Sutherland,S E, AU - Knapp,R G, AU - Lackland,D T, AU - Gazes,P C, AU - Tyroler,H A, PY - 1993/7/8/pubmed PY - 1993/7/8/medline PY - 1993/7/8/entrez KW - Americas KW - Causes Of Death KW - Cultural Background KW - Demographic Factors KW - Developed Countries KW - Differential Mortality KW - Diseases KW - Ethnic Groups KW - Heart Diseases KW - Mortality KW - North America KW - Northern America KW - Population KW - Population Characteristics KW - Population Dynamics KW - Sex Factors KW - United States SP - 73 EP - 8 JF - The New England journal of medicine JO - N. Engl. J. Med. VL - 329 IS - 2 N2 - BACKGROUND: Currently recognized risk factors for coronary artery disease have been identified primarily from investigations of white populations. In this investigation, we estimated mortality rates for coronary disease and for any cause and identified risk factors for death from coronary disease among whites and blacks. METHODS: Data collected over a 30-year period in the Charleston Heart Study were used to estimate mortality rates and quantify associations with risk factors assessed at the base-line examination in 1960 and 1961 of 653 white men, 333 black men, 741 white women, and 454 black women. RESULTS: There were no significant racial differences in the rate ratios for death from coronary disease; however, women had significantly lower death rates than men. Over the 30-year period, the mortality rates for coronary disease per 1000 person-years were 5.2 for white men (95 percent confidence interval, 4.1 to 6.3), 4.6 for black men (3.0 to 6.2), 2.1 for white women (1.6 to 2.6), and 3.2 for black women (2.3 to 4.0). Significant, or nearly significant, predictors of mortality due to coronary disease were systolic blood pressure in all four groups; serum cholesterol level among white men, white women, and black women; and smoking among white men, white women, and black men. Although the difference was not statistically significant, the risk of death from coronary disease was consistently increased among diabetics in all four groups. A higher level of education was predictive of lower rates of death due to coronary disease among white men and black women. For all causes of death taken together, the rates for blacks were higher than the rates for whites. The presence of hypertension, a history of smoking, and a history of diabetes were significant or nearly significant predictors of mortality from any cause in all four groups. CONCLUSIONS: Although the rates of death from coronary disease were somewhat lower among black men than white men and higher among black women than white women, the black:white mortality rate ratios were not statistically significant, and the major risk factors for mortality from coronary disease were similar in blacks and whites in the 30-year follow-up of the Charleston Heart Study. SN - 0028-4793 UR - https://www.unboundmedicine.com/medline/citation/8510705/Mortality_rates_and_risk_factors_for_coronary_disease_in_black_as_compared_with_white_men_and_women_ L2 - http://www.nejm.org/doi/full/10.1056/NEJM199307083290201?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -