Socioeconomic and ethnic disparities in cardiovascular risk in the United States, 2001-2006.
OBJECTIVE
To quantify 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 III 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.
Karlamangla
Arun S
AS
Division of Geriatrics, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA. akarlamangla@mednet.ucla.edu
Merkin
Sharon Stein
SS
Crimmins
Eileen M
EM
Seeman
Teresa E
TE
D000328:Adult; D001741:Black or African American / Q000208:ethnology*; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000145:classification / Q000208:ethnology*; D003920:Diabetes Mellitus / Q000208:ethnology / Q000209:etiology / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000208:ethnology / Q000209:etiology / Q000517:prevention & control; D017058:Mexican Americans / Q000208:ethnology*; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D044465:White People / Q000208:ethnology*; D055815:Young Adult