Socioeconomic and Ethnic Disparities in Cardiovascular Risk In the United States, 2001–2006

Purpose

To quantify socioeconomic status and ethnic differences in risk for coronary heart disease (CHD) accrued from major risk factors in the United States.

Methods

Data came from the National Health and Nutrition Examination Survey 2001–2006. Outcomes examined were (a) 10-year risk for CHD events as predicted by the National Cholesterol Education Program Adult Treatment Panel III 2004 Updated Guidelines; and (b) the prevalence of the metabolic syndrome and overt diabetes mellitus (a CHD risk-equivalent).

Results

Strong inverse socioeconomic gradients with risk were present in all race/ethnicity groups except foreign-born Mexican American men, and were attenuated by controls for physical activity, smoking, and abdominal obesity. In contrast, race/ethnicity disparities were seen in some but not all socioeconomic strata, with some non-Hispanic Blacks and US-born Mexican Americans having higher risk and some foreign-born Mexican Americans having lower risk.

Conclusions

Disparities in cardiovascular risk in the United States are primarily related to socioeconomic status and less to race/ethnicity. Socioeconomically disadvantaged individuals should be targeted for lifestyle counseling and early screening for risk factors, regardless of race/ethnicity, to reduce social disparities in cardiovascular outcomes.

Key Words: Socioeconomic Status, Ethnic Differences, Framingham Risk Score, Metabolic Syndrome

Selected Abbreviations and Acronyms: CHD, coronary heart disease, NCEP, National Cholesterol Education Program, NHANES, National Health and Nutrition Examination Survey, SES, socioeconomic status, US, United States