Cheung Queenie, Wharton Sean, Josse Andrea, Kuk Jennifer L
School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada.
The Wharton Medical Clinic, Hamilton, Ontario, Canada.
PLoS One. 2025 Mar 26;20(3):e0319617. doi: 10.1371/journal.pone.0319617. eCollection 2025.
To explore the association between ethnicity and cardiovascular disease (CVD) risk factors, including physical inactivity, obesity, hypertension, type 2 diabetes (T2D), lack of health insurance and low family income in a nationally representative sample of U.S. adults.
Adults from the National Health and Nutrition Examination Survey (NHANES 2011-2020, n = 17,355) were classified as having CVD risk factors based on both self-reported and metabolic data. Ethnic differences in how these CVD risk factors relate to prevalent CVD and CVD mortality was examined in Whites, Blacks, Asians and Hispanics.
Compared to Whites, significant disparities were noted in several CVD risk factors in ethnic minorities, such as lower PA, lower income, and more prevalent metabolic risk factors. Blacks and Hispanics commonly had higher prevalent CVD risk as compared to Whites even after adjusting for income and metabolic risk factors. Physical inactivity was most strongly associated with prevalent CVD and CVD mortality among Whites and Blacks. There were no ethnic differences in the inverse association between income and prevalent CVD risk, but Blacks with low income were associated with the greatest elevated CVD mortality. Hypertension and T2D were similarly related with prevalent CVD across ethnic groups, but Blacks and Hispanics with hypertension or T2D were at greater CVD mortality risk as compared to Whites.
Our study identified that socioeconomic and metabolic risk factors may relate differently to CVD outcomes among ethnic minority groups in the United States. Addressing these ethnic disparities in health warrants further investigation.
在美国成年人的全国代表性样本中，探讨种族与心血管疾病（CVD）风险因素之间的关联，这些风险因素包括身体活动不足、肥胖、高血压、2型糖尿病（T2D）、缺乏医疗保险和家庭收入低。
来自国家健康与营养检查调查（2011 - 2020年NHANES，n = 17355）的成年人根据自我报告和代谢数据被分类为患有CVD风险因素。在白人、黑人、亚洲人和西班牙裔中，研究了这些CVD风险因素与普遍存在的CVD及CVD死亡率之间的种族差异。
与白人相比，少数族裔在几个CVD风险因素方面存在显著差异，如身体活动水平较低、收入较低以及代谢风险因素更为普遍。即使在调整收入和代谢风险因素后，黑人和西班牙裔的普遍CVD风险通常仍高于白人。身体活动不足在白人和黑人中与普遍存在的CVD及CVD死亡率的关联最为密切。收入与普遍CVD风险之间的负相关不存在种族差异，但低收入黑人的CVD死亡率升高幅度最大。高血压和T2D在各民族中与普遍存在的CVD的关系相似，但与白人相比，患有高血压或T2D的黑人和西班牙裔的CVD死亡风险更高。
我们的研究发现，社会经济和代谢风险因素在美国少数族裔群体中与CVD结局的关系可能有所不同。解决这些健康方面的种族差异值得进一步研究。
