Heart Disease Risk Factors May Affect Certain Groups More

Women and blacks may face increased risk for heart disease

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Heart disease is the leading cause of death and disease in the United States. And some people may be more at risk than others — even if they have the same symptoms.

A recent study found that traditional heart disease risk factors put women and blacks more at risk for heart disease than men and whites.

"Ask your cardiologist if you are at risk for heart disease."

The lead author of this study was Susan Cheng, MD, MPH, from the Cardiovascular Division of Brigham and Women’s Hospital at Harvard Medical School in Boston.

The study included 13,541 people who underwent screenings for heart disease for the Atherosclerosis Risk in Communities study.

The patients were between 52 and 66 years old and did not have heart disease at the exam. Fifty-six percent were women and 26 percent were black.

The researchers collected data on the five most common risk factors associated with heart disease: obesity, high blood pressure, high cholesterol, diabetes and current smoking status.

The study authors followed up with the patients through 2008.

The frequency of obesity, high blood pressure and diabetes increased from the first exam to the fourth follow-up. However, the researchers found that the frequency of smoking and high cholesterol decreased during that time.

Dr. Cheng and team determined that the all of the risk factors combined increased the overall risk of heart disease by 58 percent at the time of the first exam in the late 1980s. By the end of the study, the overall risk of heart disease due to the combined risk factors decreased to a 53 percent risk.

Among the black participants, 67 percent of heart disease cases could have been avoided had all the major risk factors been eliminated in this population. This remained true for the entire study.

The overall risk for all five risk factors combined among the white participants decreased from a 56 percent increased risk of heart disease to a 48 percent increased risk by the end of the study.

The findings also revealed that high blood pressure increased the overall risk of heart disease by 36 percent in black patients — versus 21 percent in whites.

Also, the overall risk of diabetes was 28 percent for the black participants, compared to 13 percent for the white participants.

The researchers determined that the risk factors affected women differently than men.

The overall risk for heart disease associated with all the risk factors combined was higher in women toward the start of the study but higher for men by the end.

Having diabetes increased the overall risk of heart disease for women by 21 percent — versus 14 percent for men. High blood pressure was associated with an increased overall risk of 32 percent in women, compared to 19 percent in men, the researchers noted.

The participants with obesity remained at a 6 percent overall increased risk the entire study period, the study authors reported. However, the researchers said obesity remained an important risk factor for heart disease, and the seemingly small effect it had on the risk of heart disease could have been associated with the frequency of diabetes.

Dr. Cheng and team determined that the overall risk for heart disease associated with smoking decreased from 15 to 13 percent — and from 18 to 9 percent for high cholesterol.

"Our results don't suggest that a risk factor like smoking has become any less dangerous, but that fewer people are smoking," Dr. Cheng said in a press release. "In fact, for current smokers the risk of heart and vascular disease has actually gone up, possibly because remaining smokers tend to smoke more heavily or carry additional risk factors."

The authors said more research is needed to reach more exact conclusions.

The authors mentioned the study was limited because risk estimates are not typically exact. Also, the estimates could not account for continuous changes in factors that affected heart disease risk.

The findings may not be generalizable to other age, racial or geographical populations, the researchers said.

This study was published Aug. 11 in Circulation.

The National Heart, Lung, and Blood Institute provided funding. The authors did not disclose any conflicts of interest.

Review Date: 
August 11, 2014
Last Updated:
August 12, 2014