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Disparities in absolute cardiovascular risk, metabolic syndrome, hypertension, and other risk factors by income within racial/ethnic groups among middle-aged and older US people

Journal of Human Hypertension volume 37, pages 480–490 (2023)Cite this article

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Abstract

This cross-sectional study determined income disparities in age-adjusted prevalence and trends of 10-year high absolute cardiovascular disease (CVD) risk, metabolic syndrome, hypertension, diabetes, obesity, chronic kidney disease (CKD), leisure-time physical activity (LTPA), and current tobacco smoking within racial/ethnic groups in the US. National Health and Nutrition Examination Survey 2001–2016 data of 40–79-year-old people were analyzed. Survey periods were grouped as 2001–2006, 2007–2012, and 2013–2016. Race/ethnicity was grouped as non-Hispanic whites, non-Hispanic blacks, and other races/ethnicities. Three equal-sized strata (low-, middle-, and high income) were made from the family income-to-poverty ratio. Of the 25,777 participants (mean age: 55.6 years, 48% males), a majority of the studied prevalence was higher in most survey years among non-Hispanic blacks compared to non-Hispanic whites. Most studied prevalence was also higher among low-income people than middle-/high-income people. Within racial/ethnic groups, the prevalence also differed by income for high CVD risk, metabolic syndrome, hypertension, diabetes, obesity, CKD, LTPA, and tobacco smoking (P < 0.05) in most survey periods. After stratifying by race/ethnicity, the prevalence of many conditions remained disproportionately higher among low- and middle-income people, compared to those with high income during most survey periods in all racial/ethnic groups. These results reveal income in addition to race/ethnicity to be an important correlate of cardiovascular health and underscore the need to consider each when controlling for risk factors.

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Fig. 1: Prevalence and trends of high cardiovascular disease risk, metabolic syndrome, hypertension, and other cardiovascular risk factors by race/ethnicity, 2001–2016 (N = 25,777).
Fig. 2: Prevalence and trends of high cardiovascular disease risk, metabolic syndrome, hypertension, and other cardiovascular risk factors by family income-to-poverty ratio, 2001–2016 (N = 25,777).
Fig. 3: Prevalence and trends of high cardiovascular disease risk, metabolic syndrome hypertension, and diabetes by family income-to-poverty ratio within racial/ethnic groups, 2001–2016 (N = 25,777).
Fig. 4: Prevalence and trends of obesity, chronic kidney disease, no physical activity, and tobacco smoking by family income-to-poverty ratio within racial/ethnic groups, 2001–2016 (N = 25,777).

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Authors and Affiliations

  1. University of Maryland School of Medicine, Baltimore, MD, USA

    Gulam Muhammed Al Kibria, Reese Crispen & Christina Stennett

  2. Department of Emergency Medicine, College of Medicine, University of Florida, Gainesville, FL, USA

    Muhammad Abdul Baker Chowdhury

  3. Mercy Medical Center, Baltimore, MD, USA

    Nadimpali Rao

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Contributions

Concept and Design: GMAK. Analysis and interpretation of the data: GMAK, RC, and NR. First draft: GMAK, RC, CS, and MABC. Critical revision of the paper: RC, CS, MABC, and NR. Statistical analysis: GMAK.

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Correspondence to Gulam Muhammed Al Kibria.

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The original online version of this article was revised: Unfortunately, the spelling of the authors name Mohammad Abdul Baker Chowdhury was incorrect.

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Kibria, G.M.A., Crispen, R., Chowdhury, M.A.B. et al. Disparities in absolute cardiovascular risk, metabolic syndrome, hypertension, and other risk factors by income within racial/ethnic groups among middle-aged and older US people. J Hum Hypertens 37, 480–490 (2023). https://doi.org/10.1038/s41371-021-00513-8

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