Black Women at Risk Early in Life for Future Cardiovascular Disease

May 11, 2021

Conference | ACC

ACC.21: High rates of obesity, hypertension, and hyperlipidemia found in Black women in their 20s and 30s are of significant concern, says the author of a study to be presented at the ACC meeting.

Elevated prevalence among young Black women of obesity, hypertension, hyperlipidemia, and other lifestyle-related factors may place them at increased risk for early development of cardiovascular disease (CVD), according to findings of a new study to be presented at the American College of Cardiology’s 70th Annual Scientific Session, being held virtually from May 15 - 17, 2021.

Research in years past has focused attention on the burden of CVD among young Black women but the current study is unique in its shift to investigating the age at which key risk factors for CVD emerge in this population in a community setting.

Study findings revealed high rates of lifestyle-linked, and thus modifiable, risk factors in the study cohort as early as their 20s and 30s.

“Young people should be the healthiest members of our population with normal body weight and normal blood pressure,” said lead study author Nishant Vatsa, MD, an internal medicine resident at Emory University Hospital in Atlanta. He called the detection of obesity and hypertension in younger adult Black women "worrisome."

Interventions to prevent the evolution of CVD risk factors in the first place need to start early, emphasized Vatsa, citing education on healthy dietary choices and the benefits of exercise, improved access to health care and to healthy foods and safe areas for physical activity.

Vatsa and colleagues analyzed information collected between 2015-2018 from 945 Black women enrolled in the 10 000 Women community health screening project in Atlanta. Data were collected on socioeconomic (education, income, health insurance), lifestyle (smoking, diet, exercise), and CVD risk factors. The data were then separated into 3 three 20-year age cohorts:

20-39 years [n=217] 40-59 years [n=469] ≥60 years [n=259]

Cohorts were compared using pairwise analysis adjusted for socioeconomic factors.

Mean BMI for women of all age groups was ≥30 kg/m², a measure considered clinically obese.
BMI was highest in the middle age group compared to other groups (p<.05), mean (SD) 20-39y: 30.7(8.3); 40-59y: 32.4(7.0); ≥60y: 31.0(6.0) kg/m²
Systolic blood pressure levels increased with age, from an average of 122 mmHg in the youngest group (20-39y) to 142 mmHg in the oldest group (p<.001), 20-39y: 122(15.3); 40-59y: 132.7 (19.1); ≥60y: 141.8(19.5) mmHg
Total cholesterol levels were lower among younger Black women than older (p<.001), 20-39y: 173(33.3); 40-59y: 194.1(38.3); ≥60y: 196.8(39.7) mg/dL

LDL levels in the younger cohort were higher than in the middle aged and older groups (p<.001 and 0.01, respectively), 20-39y: 87.9(65.8); 40-59y: 66.7(60.5); ≥60y: 70.7(61.9) mg/dL
HDL levels were higher among the older Black women (≥60y) than among either of the younger groups (p=0.03), 20-39y: 58.1(16.6); 40-59y: 59.3(16.8); ≥60y: 63.1(17.2) mg/dL
More Black women aged ≥60 yo limited salt intake compared to younger Black women (p≤.001) and consumed fast food fewer than 3 times a week vs younger women (p<.001), [20-39y: 68.1%; 40-59y: 74.4%; ≥60y: 85.7%

“Diet and exercise play a major role in blood pressure and weight,” said Vatsa. Underscoring the findings, he issued a call to action for improved interventions:

“Primary care providers, prevention-based clinics and community organizations can facilitate interventions proven to mitigate these risk factors. Providers that treat young Black women need to be mindful of cardiovascular preventive care and be armed with resources and education.”

Vatsa also pointed to the disproportionate impact of the COVID-19 pandemic on Black and other communities of color that has both exacerbated and highlighted the barriers faced by young Black women in accessing preventive health care. Working to reduce impediments to building a heart-healthy lifestyle, said Vatsa, “can improve health in the near term and reduce the burden of heart disease for decades to come.”

Vatsa will present the study, “Cardiovascular risk factors in younger black women: results from the 10,000 Women Community Screening Project,” on Sunday, May 16, at 9:30 a.m. ET / 13:30 UTC.