Heart Disease Death Rates Among Blacks and Whites Aged ≥35 Years — United States, 1968–2015

Dyke, Miriam Van; Greer, Sophia; Odom, Erika; Schieb, Linda; Vaughan, Adam S.; Kramer, Michael R.; Casper, Michele

doi:10.15585/mmwr.ss6705a1

Cited by 114 publications

(88 citation statements)

References 35 publications

(36 reference statements)

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“…Generally, black and African American patients are at higher risk of developing kidney disease . With or without diabetes, African Americans had a higher risk of mortality secondary to cardiovascular disease compared to white individuals . Furthermore, racial and ethnic differences in haemoglobin A1c are well recognized, and black patients are known to have a higher haemoglobin A1c level .…”

Section: Introductionmentioning

confidence: 99%

“…19 With or without diabetes, African Americans had a higher risk of mortality secondary to cardiovascular disease compared to white individuals. 20 Furthermore, racial and ethnic differences in haemoglobin A1c are well recognized, and black patients are known to have a higher haemoglobin A1c level. 21 Such differences may impact the efficacy and safety of diabetes medications, particularly GLP-1RAs and SGLT-2is in different races.…”

Section: Introductionmentioning

confidence: 99%

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Do GLP‐1RAs and SGLT‐2is reduce cardiovascular events in black patients with type 2 diabetes? A systematic review and meta‐analysis

Mishriky

Powell

Wittwer

et al. 2019

Diabetes Obesity Metabolism

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Aims While recent cardiovascular safety trials (CVST) concerning newer diabetes medications included mostly white participants, results are being generalized to all races in recent guidelines. This raises a controversial question regarding the appropriateness of applying CVST data to black patients with type 2 diabetes. Materials and methods We searched for randomized trials comparing diabetes medications to placebo in type 2 diabetes and investigated three‐ or four‐point major adverse cardiovascular events (MACE). Data concerning black patients were then extracted. As the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) updated their recommendations for patients with established cardiovascular risk based on the CVST showing cardiovascular benefit, we performed a sensitivity analysis by including those trials only. Results A total of 11 trials were included, investigating a glucagon‐like peptide‐1 receptor agonist (GLP‐1RA) in five, a sodium‐glucose co‐transporter‐2 inhibitor (SGLT‐2i) in two and dipeptidyl peptidase‐4 inhibitors (DPP‐4i) in four. Of the 102 416 participants enrolled in the included trials, only 4601 were black (4.5%). Pooled results showed no significant difference in the incidence of MACE among diabetes medications (GLP‐1RA, SGLT‐2i or DPP‐4i) and placebo in black patients with type 2 diabetes (relative risk [RR] [95% CI], 0.94 [0.77,1.16]). Restricting the analysis to different classes of diabetes medication, the results remained non‐significant. Restricting the analysis to CVST with significant outcomes, the results remained non‐significant (RR [95% CI], 0.97 [0.68,1.39]). Conclusions Given that black patients with type 2 diabetes were not well represented in CVSTs and such trials were underpowered to evaluate racial differences, it remains unclear whether GLP‐1RAs or SGLT‐2is would reduce cardiovascular risk in such patients, and additional studies targeting black patients are urgently needed.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Do GLP‐1RAs and SGLT‐2is reduce cardiovascular events in black patients with type 2 diabetes? A systematic review and meta‐analysis

Mishriky

Powell

Wittwer

et al. 2019

Diabetes Obesity Metabolism

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“…Despite substantial declines in heart disease death rates in the United States (US) over the past 60 years (Cooper et al, 2000; Ford et al, 2007; Van Dyke et al, 2018), heart disease remains the leading cause of death (Xu et al). Moreover, geographic disparities in heart disease mortality have grown in the US (Casper et al, 2016; Vaughan et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

State-level minimum wage and heart disease death rates in the United States, 1980–2015: A novel application of marginal structural modeling

Dyke

Komro²,

Shah

et al. 2018

Preventive Medicine

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Despite substantial declines since the 1960’s, heart disease remains the leading cause of death in the United States (US) and geographic disparities in heart disease mortality have grown. State-level socioeconomic factors might be important contributors to geographic differences in heart disease mortality. This study examined the association between state-level minimum wage increases above the federal minimum wage and heart disease death rates from 1980 to 2015 among ‘working age’ individuals aged 35–64 years in the US. Annual, inflation-adjusted state and federal minimum wage data were extracted from legal databases and annual state-level heart disease death rates were obtained from CDC Wonder. Although most minimum wage and health studies to date use conventional regression models, we employed marginal structural models to account for possible time-varying confounding. Quasi-experimental, marginal structural models accounting for state, year, and state × year fixed effects estimated the association between increases in the state-level minimum wage above the federal minimum wage and heart disease death rates. In models of ‘working age’ adults (35–64 years old), a $1 increase in the state-level minimum wage above the federal minimum wage was on average associated with ~6 fewer heart disease deaths per 100,000 (95% CI: −10.4, −1.99), or a state-level heart disease death rate that was 3.5% lower per year. In contrast, for older adults (65+ years old) a $1 increase was on average associated with a 1.1% lower state-level heart disease death rate per year (b = −28.9 per 100,000, 95% CI: −71.1, 13.3). State-level economic policies are important targets for population health research.

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“…Heart disease is the leading cause of death among men and women in the United States and globally [16]. Major risk factors include elevated blood lipids, high blood pressure, and obesity [16].…”

Section: Heart Diseasementioning

confidence: 99%

The Potential for Plant-Based Diets to Promote Health Among Blacks Living in the United States

Sterling

2019

Nutrients

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Plant-based diets are associated with reduced risks of various chronic diseases in the general population. However, it is unclear how these benefits translate to Blacks living in the United States, who are disproportionately burdened with heart disease, cancer, diabetes, obesity, and chronic kidney disease. The objectives of this study were to: (1) review the general evidence of plant-based diets and health outcomes; (2) discuss how this evidence translates to Blacks following a plant-based diet; and (3) provide recommendations and considerations for future studies in this area. Interestingly, although the evidence supporting plant-based diets in the general population is robust, little research has been done on Blacks specifically. However, the available data suggests that following a plant-based diet may reduce the risk of heart disease and possibly cancer in this population. More research is needed on cardiovascular disease risk factors, cancer subtypes, and other chronic diseases. Further, attention must be given to the unique individual, familial, communal, and environmental needs that Blacks who follow plant-based diets may have. Interventions must be culturally appropriate in order to achieve long-term success, and providing low-cost, flavorful, and nutritious options will be important.

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Heart Disease Death Rates Among Blacks and Whites Aged ≥35 Years — United States, 1968–2015

Cited by 114 publications

References 35 publications

Do GLP‐1RAs and SGLT‐2is reduce cardiovascular events in black patients with type 2 diabetes? A systematic review and meta‐analysis

Do GLP‐1RAs and SGLT‐2is reduce cardiovascular events in black patients with type 2 diabetes? A systematic review and meta‐analysis

State-level minimum wage and heart disease death rates in the United States, 1980–2015: A novel application of marginal structural modeling

The Potential for Plant-Based Diets to Promote Health Among Blacks Living in the United States

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