ArticleCirculation2022
Associations of Clinical and Social Risk Factors With Racial Differences in Premature Cardiovascular Disease.
Article in Circulation, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
45 citing papers in PubMed, 1 synthesis or guideline pooled it, 68 citations in OpenAlex.
- Use of Antihypertensives, Blood Pressure, and Estimated Risk of Dementia in Late Life: An Individual Participant Data Meta-Analysis.JAMA network open · 2023Pooled it
- Differential Effects of an Intervention to Reduce Cardiovascular Risk for Patients With Bipolar Disorder, Schizoaffective Disorder, or Schizophrenia: A Randomized Clinical Trial.The Journal of clinical psychiatry · 2023Trial
- Drivers of Atherosclerotic Cardiovascular Disease in South Asians: Current Insights and Future Directions.JACC. Asia · 2026Review
- External validation of American heart association predicting risk of cardiovascular disease EVENTs (PREVENT) equations in a Chinese population.Scientific reports · 2026Article
- Visual Impairment and Cardiovascular Risk Factors in Hispanic and Latino Adults.JAMA network open · 2026Article
- Mediation of coronary heart disease risk by genetic, socio-environmental, and lifestyle factors across racial groups.American journal of preventive cardiology · 2026Article
- The influence of ethnicity and sex on lipid profile and cardiovascular risk factors: a population-based study.Lipids in health and disease · 2026Article
- Sex Differences in Age of Onset of Premature Cardiovascular Disease and Subtypes: The Coronary Artery Risk Development in Young Adults Study.Journal of the American Heart Association · 2026Article
- Cardiovascular risk assessed by the conicity index in Brazilian adults: findings from the national health survey.Frontiers in nutrition · 2026Article
- Translational Lifestyle Medicine Approaches to Cardiovascular-Kidney-Metabolic Syndrome.Healthcare (Basel, Switzerland) · 2025Review
- Cardiometabolic deaths in premenopausal black and white women.American journal of preventive cardiology · 2025Article
- Severe housing cost burden and premature cardiovascular mortality.American journal of preventive cardiology · 2025Article
- Association Between Educational Inequality and Income Inequality With Metabolic Diseases and Cause-Specific Mortality.Clinical cardiology · 2025Article
- Cardiovascular Health in the Transition From Adolescence to Emerging Adulthood: A Scientific Statement From the American Heart Association.Journal of the American Heart Association · 2025Review
- Developing a Novel Index for Individual-Level Social Determinants and Cardiovascular Diseases in the Coronary Artery Risk Development in Young Adults (CARDIA) Study.International journal of environmental research and public health · 2025Article
- Impact of Social Determinants of Health on Cardiovascular Disease.Journal of the American Heart Association · 2025Review
- Cardiometabolic deaths in black and white men: Tracing the risks from early- to mid-adulthood.Preventive medicine reports · 2025Article
- American society for preventive cardiology 2024 cardiovascular disease prevention: Highlights and key sessions.American journal of preventive cardiology · 2025Review
- Association of neighborhood-level socioeconomic disadvantage and Life's Essential 8 in early pregnancy.American journal of preventive cardiology · 2025Article
- 2025 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association.Circulation · 2025Review
Corrections and comments
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Authors and funding
14 authors at 7 institutions in 2 countries.
Funding
Abstract
backgroundRacial differences in cardiovascular disease (CVD) are likely related to differences in clinical and social factors. The relative contributions of these factors to Black-White differences in premature CVD have not been investigated.
methodsIn Black and White adults aged 18 to 30 years at baseline in the CARDIA study (Coronary Artery Risk Development in Young Adults), the associations of clinical, lifestyle, depression, socioeconomic, and neighborhood factors across young adulthood with racial differences in incident premature CVD were evaluated in sex-stratified, multivariable-adjusted Cox proportional hazards models using multiply imputed data assuming missing at random. Percent reduction in the β estimate (log-hazard ratio [HR]) for race quantified the contribution of each factor group to racial differences in incident CVD.
resultsAmong 2785 Black and 2327 White participants followed for a median 33.9 years (25th-75th percentile, 33.7-34.0), Black (versus White) adults had a higher risk of incident premature CVD (Black women: HR, 2.44 [95% CI, 1.71-3.49], Black men: HR, 1.59 [1.20-2.10] adjusted for age and center). Racial differences were not statistically significant after full adjustment (Black women: HR, 0.91 [0.55-1.52], Black men: HR 1.02 [0.70-1.49]). In women, the largest magnitude percent reduction in the β estimate for race occurred with adjustment for clinical (87%), neighborhood (32%), and socioeconomic (23%) factors. In men, the largest magnitude percent reduction in the β estimate for race occurred with an adjustment for clinical (64%), socioeconomic (50%), and lifestyle (34%) factors.
conclusionsIn CARDIA, the significantly higher risk for premature CVD in Black versus White adults was statistically explained by adjustment for antecedent multilevel factors. The largest contributions to racial differences were from clinical and neighborhood factors in women, and clinical and socioeconomic factors in men.
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