Chicago, IL - In the largest study of its kind to date, researchers have shown that the association between traditional cardiovascular risk factors and cardiovascular disease mortality is similar between races [1].

Dr Mercedes R Carnethon (Northwestern University, Chicago, IL) and colleagues report their work in the June 12, 2006 issue of the Archives of Internal Medicine.

"This shows that there is a need for further investigation into what social, environmental, or biological factors do cause the disparities in CVD morbidity and mortality that we see between races," she told heartwire.

Carnethon and colleagues explain that early reports on this subject suggested that there was a significantly smaller association between traditional risk factors and CVD among blacks compared with whites, but more recent evidence finds a similar pattern and strength of association between ethnic groups.

This new study is unique, she told heartwire, not only because it is the largest to date, but it also has the longest follow-up and includes black and white men and women who were all employed in the urban US North (the Chicago Heart Association Detection Project in Industry).

They followed 3741 black and 33 246 white men and women without a history of myocardial infarction aged between 18 and 64 at baseline (1967-1973). Blood pressure, total cholesterol levels, body-mass index, cigarette smoking, and physician-diagnosed diabetes were assessed at baseline using standard methods.

"In general, the magnitude and direction of associations between traditional risk factors and CVD mortality were similar by race," the researchers note.

There were just a couple of exceptions—the adjusted hazard ratio of CVD mortality per 12 mm Hg diastolic BP was 1.31 in white women compared with 1.08 in black women, and for cholesterol (per 40 mg/dL) it was 1.21 in white men compared with 0.94 in black men. However, these small differences were primarily in the strength, not the direction, of association, they add.

Carnethon says the only demographic factor that was included in their multivariate analysis was education, so it is possible that other socioeconomic factors played a confounding role. Although all the study subjects were employed, blacks "were more likely to be in lower-status occupations," and not all employees would necessarily have had health insurance 30 years ago, she says.

Nevertheless, she believes her findings are robust and says the large racial disparity in the prevalence of risk factors in the US population—namely higher rates of obesity, hypertension, and diabetes in blacks compared with whites—means that it is vital that healthcare professionals closely monitor and work to control traditional CVD risk factors in all adults.