Elevated Fibrinogen Predicts Atherosclerosis.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 3188-3188
Author(s):  
David Green ◽  
Nancy Foiles ◽  
Cheeling Chan ◽  
Pamela J. Schreiner ◽  
David Jacobs ◽  
...  
Keyword(s):  
Young Adults ◽  
Coronary Artery ◽  
Black Women ◽  
Black Men ◽  
White Women ◽  
Multivariable Analysis ◽  
White Men ◽  
Race And Gender ◽  
Hemostatic Factors ◽  
And Gender

Abstract Elevated levels of hemostatic factors are observed in patients with atherosclerosis, but whether they promote plaque formation or are a consequence of the disease is uncertain. To examine this issue, we used data from a large biracial cohort of young adults (Coronary Artery Risk Development in Young Adults [CARDIA]) followed up for 13 years, to examine the relationships of hemostatic factors - fibrinogen, factors VII and VIII, and von Willebrand factor (vWF) - with coronary artery calcium (CAC) and carotid intimal-medial thickness (IMT). Complete data were available on 1382 participants, whose mean age was 32 years at enrollment. The age, race, and gender-adjusted prevalence of CAC for increasing quartiles of fibrinogen levels was: 14.0%, 15.0%, 19.6%, and 28.4% (p <0.001 for trend). After further adjustment for BMI, smoking, systolic BP, and total cholesterol, the prevalence of CAC for increasing quartiles of fibrinogen was 15.5%, 16.0%, 19.0%, and 26.4% (p <0.001 for trend). Similar trends were observed for IMT (age, race, and gender-adjusted, p<0.001; multivariable adjusted, p=0.022). When race and gender subgroups were further analyzed, the prevalence of CAC was associated with fibrinogen levels in women and white men after age adjustment, and in women on multivariable analysis. IMT scores adjusted for age were associated with elevated fibrinogen levels in all except black men, and in black women after multivariable adjustment (p=0.003). While the prevalence of CAC was not associated with increasing quartiles of FVII, FVIII, or vWF, IMT scores were associated with elevated FVII on multivariable analysis in white women (p=0.006) and with vWF antigen in white men on age-adjusted (p=0.004) and multivariable analysis (p=0.013). There were no significant associations of hemostatic factors with either the prevalence of CAC or IMT in black men. Participants were categorized as to whether they had 0, 1, or more than 1 hemostatic factors in the highest quartile. After adjustment for age, race, and gender, hemostatic group classification was associated linearly with the prevalence of CAC (p<0.001 for trend) and IMT score (p=0.01 for trend). In conclusion, the main finding from this study is that elevated levels of fibrinogen in persons aged 25 to 37 are associated with the later appearance of subclinical markers of cardiovascular disease. These associations were observed in whites and black women, but not black men. We suggest that atherosclerosis became established during the 13 year observation period, and that increased fibrinogen may have been a contributing factor or a marker for disease development.

Abstract MP050: Race and Gender Group Specific Trends in Length of Stay for Acute Myocardial Infarction: The Atherosclerosis Risk in Communities (ARIC) study, 1987–2008

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Laura R Loehr ◽  
Xiaoxi Liu ◽  
C. Baggett ◽  
Cameron Guild ◽  
Erin D Michos ◽  
...  
Keyword(s):  
Black Women ◽  
Length Of Stay ◽  
Black Men ◽  
White Women ◽  
White Men ◽  
Quadratic Term ◽  
Race And Gender ◽  
Insurance Type ◽  
And Gender ◽  
Aric Study

Introduction: Since the 1980’s, length of stay (LOS) for acute MI (AMI) has declined in the US. However, little is known about trends in LOS for non-white racial groups and whether change in LOS is related to insurance type or hospital complications. Methods: We determined 22 year trends in LOS for nonfatal (definite or probable) AMI among black and white residents age 35–74 in 4 US communities (N=396,514 in 2008 population) under surveillance in the ARIC Study. Events were randomly sampled and independently validated using a standardized algorithm. All analyses accounted for sampling scheme. We excluded MI events which started after admission (n=1,677), events within 28 days for the same person (n=3,817), hospital transfers (n=571), and those with LOS=0 or LOS >66 (top 0.5% of distribution, N= 144) leaving 22,258 weighted events for analysis. The average annual change in log LOS was modeled using weighted linear regression with year as a quadratic term. All models adjusted for age and secondary models adjusted for insurance type (Medicare, Medicaid, private, or other), and complications during admission (cardiac arrest, cardiogenic shock, or heart failure). Results: The average age-adjusted LOS from 1987 to 2008 was reduced by 5 days in black men (9.5 to 4.5 days); 4.6 days in white women (9.4 to 4.8 days); 4 days in white men (8.3 to 4.3 days) and 3.6 days in black women (9.0 to 5.4 days). Between 1987 and 2008, the age-adjusted average annual percent change (with 95% CI) in LOS was largest for white men at −4.40 percent per year (−4.91, −3.89) followed by −3.89 percent (−4.52, −3.26) for white women, −3.72 percent (−4.46, −2.89) for black men, and −2.94 percent (−3.92, −1.96) for black women (see Figure). Adjustment for insurance type, and complications did not change the pattern by race and gender. Conclusions: Between 1987 and 2008, LOS for AMI declined significantly and similarly in men and women, blacks and whites. These changes appear independent of differences in insurance type and hospital complications among race-gender groups.

scholarly journals Cardiovascular Health at the Intersection of Race and Gender: Identifying Life-Course Processes to Reduce Health Disparities

2020 ◽  
Author(s):  
Chioun Lee ◽  
Soojin Park ◽  
Jennifer M Boylan
Keyword(s):  
Black Women ◽  
Life Course ◽  
Black Men ◽  
White Women ◽  
Cardiovascular Health ◽  
Perceived Discrimination ◽  
White Men ◽  
Race And Gender ◽  
And Gender ◽  
Unmeasured Confounders

Abstract Objective Cardiovascular health (CVH) is associated with reductions in age-related disease and later-life mortality. Black adults, particularly Black women, are less likely to achieve ideal CVH. Guided by intersectionality and life-course approaches, we examine to what degree (a) disparities in CVH exist at the intersection of race and gender and (b) CVH disparities would be reduced if marginalized groups had the same levels of resources and adversities as privileged groups. Methods We used biomarker subsamples from the Midlife in the United States (MIDUS) core and Refresher studies (N = 1,948). Causal decomposition analysis was implemented to test hypothetical interventions to equalize the distribution of early-life adversities (ELAs), perceived discrimination, or midlife SES between marginalized and privileged groups. We conducted sensitivity analyses to determine to what degree unmeasured confounders would invalidate our findings. Results White women have the highest CVH score, followed by White men, Black men, and Black women. Intervening on ELAs would reduce the disparities: White men vs. Black women (30% of reduction) and White women vs. Black women (15%). Intervening on perceived discrimination would not substantially change initial disparities. Intervening on midlife SES would yield large disparity reductions: White men vs. Black men (64%), White men vs. Black women (60%), and White women vs. Black women (27%). These reductions are robust to unmeasured confounders. Discussion Providing economic security in adulthood for Blacks may help reduce racial disparities in CVH. Preventing exposure to ELAs among Black women may reduce their vulnerability to cardiovascular disease, compared to White adults.

scholarly journals Inter-Individual Variability in Trajectories of Functional Limitations by Race/Gender

2019 ◽  
Vol 75 (5) ◽  
pp. 1082-1092
Author(s):  
Jielu Lin
Keyword(s):  
Black Women ◽  
Life Course ◽  
Social Inequality ◽  
Black Men ◽  
White Women ◽  
Interindividual Variability ◽  
Functional Limitations ◽  
White Men ◽  
Race And Gender ◽  
And Gender

Abstract Objective Several theories emphasize that systematic interindividual divergence is a key feature of cohort aging and evidence for accumulative social inequality over the life course. While many have documented widening health gaps with age between subgroups, such divergence is only one aspect of the broader social inequality based on race and gender. This article examines patterns of interindividual variability in trajectories of functional limitations within each race/gender. Methods Using data from the Health and Retirement Study (HRS)’s HRS cohort (born 1931–1941), I estimate growth curves of functional limitations with Level 2 heteroscedasticity, allowing interindividual variability to differ across 4 groups: white men, black men, white women, and black women. I examine race/gender differences in the age-based pattern of interindividual variability using an interquartile range of estimated individual trajectories. Results Black men, white women, and black women have greater interindividual variability in functional limitations than do white men. Interindividual variability increases systematically with age at similar rates for all groups but black women. Discussion Functional limitations become more heterogeneous with age for the entire cohort and for white men, white women, and black men. Future research should identify life-course processes that generate the race and gender patterning of interindividual variability in late-life health.

Abstract 131: Racial Differences in Nocturnal Hypertension and Non-dipping Blood Pressure: The Coronary Artery Risk Development in Young Adults (CARDIA) Study

Hypertension ◽  
2017 ◽  
Vol 70 (suppl_1) ◽  
Author(s):  
Paul Muntner ◽  
John N Booth ◽  
Stephen J Thomas ◽  
Luqin Deng ◽  
Joseph E Schwartz ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Young Adults ◽  
Coronary Artery ◽  
Black Women ◽  
Black Men ◽  
White Women ◽  
White Men ◽  
Self Report ◽  
Nocturnal Hypertension ◽  
Multivariable Adjustment

Risk factors for nocturnal hypertension are more common among blacks compared with whites. We hypothesized nocturnal hypertension and nocturnal non-dipping BP are more common among blacks compared with whites. We analyzed data for 781 participants of the population-based Coronary Artery Risk Development in Young Adults (CARDIA) study who completed ambulatory blood pressure (BP) monitoring (ABPM) in 2015-2016. Awake and sleep periods were defined using actigraphy and self-report. Nocturnal hypertension was defined as mean sleep systolic BP (SBP)/diastolic BP (DBP) ≥ 120/70 mm Hg. Non-dipping SBP and DBP, separately, were defined as a decline in mean sleep BP, relative to mean awake BP < 10%. The mean age of participants was 54.7 years, 21.1% were white women, 38.5% were black women, 16.8% were white men and 23.6% were black men. The prevalence of nocturnal hypertension was 18.2% and 44.5% among white and black women, respectively, and 35.9% and 59.8% among white and black men, respectively. After multivariable adjustment, the prevalence of nocturnal hypertension was higher among black women, white men and black men, each compared with white women (Table). The prevalence of non-dipping SBP was 21.2% and 40.9% among white and black women, respectively, and 19.8% and 37.5% among white and black men, respectively. After multivariable adjustment, non-dipping SBP was more common among black women and black men compared with white women. There were no statistically significant differences in non-dipping DBP across race-gender after multivariable adjustment. Nocturnal hypertension and non-dipping SBP are more common among blacks compared with whites even after adjustment for mean BP.

scholarly journals Cardiovascular Health at the Intersection of Race and Gender: Life-Course Processes to Reduce Health Disparities

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 506-507
Author(s):  
Chioun Lee ◽  
Soojin Park ◽  
Jennifer Boylan
Keyword(s):  
Black Women ◽  
Black Men ◽  
White Women ◽  
Cardiovascular Health ◽  
White Men ◽  
The United States ◽  
Economic Security ◽  
Race And Gender ◽  
And Gender ◽  
Unmeasured Confounders

Abstract Objective: Higher cardiovascular health (CVH) scores are significantly associated with reductions in aging-related disease and mortality but racial minorities exhibit poor CVH. We examine the degree to which (a) disparities in CVH exist at the intersection of race and gender and (b) CVH disparities would be reduced if marginalized groups had the same levels of resources and adversities as privileged groups. Methods: We used biomarker subsamples from the Midlife in the United States (MIDUS) core study and Refresher studies (N=1,948). Causal decomposition analysis was implemented to test hypothetical interventions to equalize the distribution of early-life adversities (ELAs), perceived discrimination, or adult SES between marginalized and privileged groups. We conducted sensitivity analyses to determine to what degree unmeasured confounders would invalidate our findings. Results: White women have the highest CVH score, followed by White men, Black men, and Black women. Intervening on ELAs reduces the disparities: White men vs. Black women (30% of reduction) and White women vs. Black women (15%). Intervening on adult SES provides large disparity reductions: White men vs. Black men (79%), White men vs. Black women (70%), White women vs. Black men (25%), and White women vs. Black women (32%). Among these combinations, interventions on ELAs and adult SES are robust to unmeasured confounders. However, intervening on discrimination makes little change in initial disparities. Discussion: Economic security in midlife for Blacks helps reduce racial disparities in cardiovascular health. Preventing exposure to ELAs among Black women may reduce their vulnerability to cardiovascular disease, compared to Whites.

Literacy Skills and Earnings: Race and Gender Differences

2007 ◽  
Vol 34 (3-4) ◽  
pp. 231-243 ◽  
Author(s):  
Roberto M. De Anda ◽  
Pedro M. Hernandez
Keyword(s):  
Black Women ◽  
Black Men ◽  
Adult Literacy ◽  
White Men ◽  
Literacy Skills ◽  
Literacy Skill ◽  
Men And Women ◽  
Race And Gender ◽  
And Gender ◽  
Document Literacy

This study examines differences in returns to literacy skills on earnings of black and white men and women. Literacy skill is a composite measure of three scales: reading comprehension, document literacy (the ability to locate and use information in, say, tables and graphs), and mathematics proficiency. Using data from the National Adult Literacy Survey (NALS), we estimate earnings determination models separately for each racial/gender group. Our findings show that the effect of literacy on earnings varies by race and gender. Literacy skills favorably rewarded black men relative to black women and white men and women, net of education and other relevant variables. More importantly, literacy completely explained the effect of a high school diploma and some college on earnings of black men. We conclude that the economic importance of literacy skills is particularly salient for less-educated black men.

Job Characteristics and Well-Being at Midlife: Ethnic and Gender Comparisons

1989 ◽  
Vol 13 (2) ◽  
pp. 223-235 ◽  
Author(s):  
Susan E. Crohan ◽  
Toni C. Antonucci ◽  
Pamela K. Adelmann ◽  
Lerita M. Coleman
Keyword(s):  
Life Satisfaction ◽  
Black Women ◽  
Black Men ◽  
Perceived Control ◽  
White Women ◽  
Occupational Status ◽  
White Men ◽  
Well Being ◽  
Role Stress ◽  
And Gender

Lacking in the research on work and well-being is a focus on the characteristics of the employment role that contribute to well-being and their differential relations across ethnicity and gender. White and Black women and men at midlife (ages 40–64) were studied. The samples were drawn from two national surveys and included 186 White women, 202 White men, 254 Black women, and 169 Black men. Multiple regression analyses were conducted to assess the relation of work commitment, job satisfaction, role stress, occupational status and personal income to perceived control, life satisfaction, and happiness. Marital status, age, and hours worked were included as control variables. Results indicate that job satisfaction is positively related to life satisfaction for all four groups, and to happiness for White women and Black men. Personal income is positively related to perceived control for Black women and White men, and to life satisfaction for White women. Occupational status is positively related to perceived control for White and Black women; role stress is negatively related to life satisfaction among White men, and to happiness among Black women. Among the control variables, being married is positively related to well-being for all four race-sex groups.

scholarly journals The Intersection of Racial and Gender Attitudes, 1977 through 2018

2021 ◽  
pp. 000312242110335
Author(s):  
William J. Scarborough ◽  
Joanna R. Pepin ◽  
Danny L. Lambouths ◽  
Ronald Kwon ◽  
Ronaldo Monasterio
Keyword(s):  
Black Women ◽  
Black Men ◽  
Latent Class ◽  
White Women ◽  
General Social Survey ◽  
The Other ◽  
Gender Attitudes ◽  
Race And Gender ◽  
Gender Egalitarianism ◽  
And Gender

Intersectionality scholars have long identified dynamic configurations of race and gender ideologies. Yet, survey research on racial and gender attitudes tends to treat these components as independent. We apply latent class analysis to a set of racial and gender attitude items from the General Social Survey (1977 to 2018) to identify four configurations of individuals’ simultaneous views on race and gender. Two of these configurations hold unified progressive or regressive racial and gender attitudes. The other two formations have discordant racial and gender attitudes, where progressive views on one aspect combine with regressive views on the other. In the majority of survey years, the most commonly held configuration endorsed gender equality but espoused new racialist views that attributed racial disparities to cultural deficiencies. This perspective has become increasingly common since 1977 and is most prevalent among White women and White men, likely due to racial-group interest. Black women and Black men, in contrast, are more likely to embrace progressive racial and gender attitudes. We argue that White men’s gender egalitarianism may be rooted in self-interest, aimed at acquiring resources through intimate relationships. In contrast, Black men adopt progressive racial and gender attitudes to form a necessary coalition with Black women to challenge racism.

Abstract P257: The Association of Metabolic Risk and Physical Activity Trajectories: CARDIA

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Sarah M Camhi ◽  
Peter T Katzmarzyk ◽  
Stephanie Broyles ◽  
Timothy S Church ◽  
Arlene L Hankinson ◽  
...  
Keyword(s):  
Physical Activity ◽  
Young Adults ◽  
Black Women ◽  
Black Men ◽  
Repeated Measures ◽  
White Women ◽  
Smoking Status ◽  
White Men ◽  
Metabolic Risk ◽  
Linear Modeling

Purpose: To determine whether baseline metabolic risk in young adults is associated with physical activity (PA) trajectories over 20 years. Methods: The sample included young adults from the Coronary Artery Risk Development in Young Adults (CARDIA) study, baseline ages 18–30 years (n= 4161). PA was determined from self-reported questionnaire at baseline and at years 2,5,7,10,15 and 20 of follow-up. Baseline metabolic risk was calculated using age-adjusted principal components analysis (elevated=top 10% of first factor), within sex-by-race groups, from mean arterial pressure (1/3(SBP-DBP)+DBP), glucose, waist circumference, triglycerides, and high-density lipoprotein cholesterol. Repeated measures general linear modeling was used to generate PA trajectories over 20 years, separately in black men, white men, black women and white women, adjusting for age and smoking status. Time by metabolic risk interaction terms did not contribute significantly to any model for any sex-by-race group and were therefore not included in final models. Results: In black men, white men, and white women, PA (in exercise units) at baseline was significantly lower among those with elevated metabolic risk (elevated risk vs. normal risk: black men 473.0 ± 27.0 vs. 572.0 ± 22.7; white men: 498.0 ±20.6 vs. 568.7 ± 17.3; white women: 402.4 ± 17.0 vs. 481.1 ± 14.3), and these differences persisted over 20 years (black men: −98.9 ± 16.4, white men: −70.8 ± 12.5 , white women: −78.7 ± 10.2; all p<0.0001). There were no significant differences in PA by metabolic risk in black women (307.2 ± 15.5 vs. 317.4 ± 13.1, difference: −10.1 ± 9.3, p =0.27). Conclusion: Elevated metabolic risk is associated with lower levels of PA in early adulthood, and these differences persist over 20 years. Despite these lower levels at baseline, the PA trajectory declines at similar rates for those with and without elevated metabolic risk. Young adults with elevated metabolic risk are important to identify early, in order to prevent PA level gap which remains over 20 years between those with and without elevated metabolic risk.

Black-White Differences in Ischemic Stroke Risk Factor Burden in Young Adults

Stroke ◽  
2021 ◽  
Author(s):  
Elizabeth M. Aradine ◽  
Kathleen A. Ryan ◽  
Carolyn A. Cronin ◽  
Marcella A. Wozniak ◽  
John W. Cole ◽  
...  
Keyword(s):  
Young Adults ◽  
Ischemic Stroke ◽  
Black Women ◽  
Black Men ◽  
White Women ◽  
Population Attributable Risk ◽  
White Men ◽  
Attributable Risk ◽  
Black Patients ◽  
Population Attributable Risk Percent

Background and Purpose: Although the US Black population has a higher incidence of stroke compared with the US White population, few studies have addressed Black-White differences in the contribution of vascular risk factors to the population burden of ischemic stroke in young adults. Methods: A population-based case-control study of early-onset ischemic stroke, ages 15 to 49 years, was conducted in the Baltimore-Washington DC region between 1992 and 2007. Risk factor data was obtained by in-person interview in both cases and controls. The prevalence, odds ratio, and population-attributable risk percent (PAR%) of smoking, diabetes, and hypertension was determined among Black patients and White patients, stratified by sex. Results: The study included 1044 cases and 1099 controls. Of the cases, 47% were Black patients, 54% were men, and the mean (±SD) age was 41.0 (±6.8) years. For smoking, the population-attributable risk percent were White men 19.7%, White women 32.5%, Black men 10.1%, and Black women 23.8%. For diabetes, the population-attributable risk percent were White men 10.5%, White women 7.4%, Black men 17.2%, and Black women 13.4%. For hypertension, the population-attributable risk percent were White men 17.2%, White women 19.3%, Black men 45.8%, and Black women 26.4%. Conclusions: Modifiable vascular risk factors account for a large proportion of ischemic stroke in young adults. Cigarette smoking was the strongest contributor to stroke among White patients while hypertension was the strongest contributor to stroke among Black patients. These results support early primary prevention efforts focused on smoking cessation and hypertension detection and treatment.

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