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In the U.S., death rates from heart disease are higher among blacks and other racial and ethnic minorities than among whites. The American Heart Association uses a set of goals — called Life's Simple 7 (LS7) — to help improve cardiovascular (CV) health through primary prevention; LS7 assesses control of seven health factors and behaviors (blood pressure, lipids, blood glucose, weight, physical activity, diet, and smoking).
To determine how CV health is changing in the U.S., investigators performed a cross-sectional observational study using National Health and Nutrition Examination Survey (NHANES) data from 1988 to 2014 to evaluate changes in health measures (specifically LS7) in >40,000 adult (age, >25) whites, blacks, and self-identified Mexican Americans without known CV disease. After adjustment for age, sex, education, and income, disparities in CV health between whites and the other groups narrowed over time. However, that narrowing was due to worse CV health measures in whites, rather than improved health measures in blacks or Mexican Americans.
Brown AF et al. Trends in racial/ethnic and nativity disparities in cardiovascular health among adults without prevalent cardiovascular disease in the United States, 1988 to 2014. Ann Intern Med 2018 Mar 20; [e-pub]. (https://doi.org/10.7326/M17-0996)
Mensah GA.The black–white cardiovascular health disparity is narrowing, but not for the reason you think. Ann Intern Med 2018 Mar 20; [e-pub]. (https://doi.org/10.7326/M18-0349)
Comment
The results here are disappointing: Most Americans have suboptimal CV health parameters as measured by LS7, suggesting that U.S. CV health is declining overall. These findings should influence healthcare organizations, payors, and individual clinicians to double down on preventive efforts for all Americans so that our CV outcomes do not regress — and, hopefully, that they improve — in coming years.