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

PURPOSE: To quantity 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 111 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. Ann Epidemiol 2010;20:617-628. (C) 2010 Elsevier Inc. All rights reserved.