Racial Differences in the Incidence of Cardiovascular Risk Factors in Older Black and White Adults

ObjectivesTo describe the incidence of cardiovascular risk factors, or race-related disparities in incidence, across the age spectrum in adults. DesignLongitudinal cohort. SettingNational sample. ParticipantsCommunity-dwelling black and white adults recruited between 2003 and 2007. MeasurementsIncident hypertension, diabetes mellitus, dyslipidemia and atrial fibrillation over 10 years of follow-up in 10,801 adults, stratified according to age (45-54, 55-64, 65-74, 75). ResultsThere was no evidence (P .68) of an age-related difference in the incidence of hypertension for white men (average incidence 38%), black men (48%), or black women (54%), although for white women incidence increased with age (45-54, 27%; 75, 40%). Incidence of diabetes mellitus was lower at older ages for white men (45-54, 15%; 75, 8%), black men (45-54, 29%; 75, 13%), and white women (45-54, 11%; 75, 4%), although there was no evidence (P = .11) of age-related changes for black women (average incidence 21%). For dyslipidemia, incidence for all race-sex groups was approximately 20% for aged 45 to 54 but approximately 30% for aged 54 to 64 and 65 to 74 and approximately 22% for aged 75 and older. Incidence of atrial fibrillation was low at age 45 to 54 (<5%) but for aged 75 and older was approximately 20% for whites and 11% for blacks. The incidence of hypertension, diabetes mellitus, and dyslipidemia was higher in blacks across the age spectrum but lower for atrial fibrillation. ConclusionIncidence of risk factors remains high in older adults. Blacks have a higher incidence of hypertension, diabetes mellitus, and dyslipidemia after age 45, underscoring the ongoing importance of prevention of all three conditions in mid- to later life.