George Howard1, Monika M Safford2, Claudia S Moy3, Virginia J Howard4, Dawn O Kleindorfer5, Fredrick W Unverzagt6, Elsayed Z Soliman7, Matthew L Flaherty5, Leslie A McClure8, Daniel T Lackland9, Virginia G Wadley10, LeaVonne Pulley11, Mary Cushman12. 1. Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama. 2. Division of General Internal Medicine, Weill Cornell Medical College, New York, New York. 3. National Institute of Neurological Disorders and Stroke, Bethesda, Maryland. 4. Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama. 5. Department of Neurology, University of Cincinnati, Cincinnati, Ohio. 6. Department of Psychology, Indiana University, Indianapolis, Indiana. 7. Department of Epidemiology, School of Medicine, Wake Forest University, Winston-Salem, North Carolina. 8. Department of Epidemiology and Biostatistics, School of Public Health, Drexel University, Philadelphia, Pennsylvania. 9. Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina. 10. Department of Gerontology, Geriatrics and Palliative Care, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama. 11. Department of Health Behavior and Health Education, University of Arkansas for Medical Sciences, Little Rock, Arkansas. 12. Department of Medicine, School of Medicine, University of Vermont, Burlington, Vermont.
Abstract
OBJECTIVES: To describe the incidence of cardiovascular risk factors, or race-related disparities in incidence, across the age spectrum in adults. DESIGN: Longitudinal cohort. SETTING: National sample. PARTICIPANTS: Community-dwelling black and white adults recruited between 2003 and 2007. MEASUREMENTS: Incident 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). RESULTS: There 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. CONCLUSION: Incidence 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.
OBJECTIVES: To describe the incidence of cardiovascular risk factors, or race-related disparities in incidence, across the age spectrum in adults. DESIGN: Longitudinal cohort. SETTING: National sample. PARTICIPANTS: Community-dwelling black and white adults recruited between 2003 and 2007. MEASUREMENTS: Incident 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). RESULTS: There 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. CONCLUSION: Incidence 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.
Authors: Elsayed Z Soliman; George Howard; James F Meschia; Mary Cushman; Paul Muntner; Patrick M Pullicino; Leslie A McClure; Suzanne Judd; Virginia J Howard Journal: Stroke Date: 2011-08-04 Impact factor: 7.914
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Authors: S L Rywik; O D Williams; A Pajak; G Broda; C E Davis; E Kawalec; T A Manolio; W Piotrowski; R Hutchinson Journal: J Hypertens Date: 2000-08 Impact factor: 4.844
Authors: April P Carson; George Howard; Gregory L Burke; Steven Shea; Emily B Levitan; Paul Muntner Journal: Hypertension Date: 2011-04-18 Impact factor: 10.190
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Authors: Karen C Albright; Lei Huang; Justin Blackburn; George Howard; Michael Mullen; Vera Bittner; Paul Muntner; Virginia Howard Journal: Neurology Date: 2018-10-03 Impact factor: 9.910
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Authors: Saad Samargandy; Karen A Matthews; Maria M Brooks; Emma Barinas-Mitchell; Jared W Magnani; Imke Janssen; Steven M Hollenberg; Samar R El Khoudary Journal: Arterioscler Thromb Vasc Biol Date: 2020-01-23 Impact factor: 8.311