Ischemic heart disease and stroke mortality in African-American, Hispanic, and non-Hispanic white men and women, 1985 to 1991.

We compare recent trends in ischemic heart disease (IHD) and stroke mortality in California among the 6 major sex-racial or -ethnic groups. Rates of age-specific and -adjusted mortality were calculated for persons aged 35 and older during the years 1985 to 1991. Log-linear regression modeling was performed to estimate the average annual percentage change in mortality. During 1985 through 1991, the mortality for IHD and stroke was generally highest for African Americans, intermediate for non-Hispanic whites, and lowest for Hispanics. Age-adjusted mortality for IHD declined significantly in all sex-racial or -ethnic groups except African-American women, and stroke rates declined significantly in all groups except African-American and Hispanic men. African Americans had excess IHD mortality relative to non-Hispanic whites until late in life, after which mortality of non-Hispanic whites was higher. Similarly, African Americans and Hispanics had excess stroke mortality relative to non-Hispanic whites early in life, whereas stroke mortality in non-Hispanic whites was higher at older ages. The lower IHD and stroke mortality among Hispanics was paradoxical, given the generally adverse risk profile and socioeconomic status observed among Hispanics. An alarmingly high prevalence of self-reported cardiovascular disease risk factors in 1994 to 1996, particularly hypertension, leisure-time sedentary lifestyle, and obesity, is a serious public health concern, with implications for future trends in cardiovascular disease mortality. Of particular concern was the growing disparities in stroke and IHD mortality among younger-aged African Americans relative to Hispanics and non-Hispanic whites.

[1]  R. Gillum,et al.  The end of the long-term decline in stroke mortality in the United States? , 1997, Stroke.

[2]  D. Williams,et al.  Race and health: basic questions, emerging directions. , 1997, Annals of epidemiology.

[3]  D. Labarthe,et al.  Greater incidence of hospitalized myocardial infarction among Mexican Americans than non-Hispanic whites. The Corpus Christi Heart Project, 1988-1992. , 1997, Circulation.

[4]  C. Caspersen,et al.  Risk Factors for Sudden Coronary Death in the United States , 1997, Epidemiology.

[5]  H. Kraemer,et al.  Hispanic versus white smoking patterns by sex and level of education. , 1995, American journal of epidemiology.

[6]  P. Sorlie,et al.  Ethnic Differences in Stroke Mortality Between Non‐Hispanic Whites, Hispanic Whites, and Blacks: The National Longitudinal Mortality Study , 1994, Stroke.

[7]  D. Labarthe,et al.  Greater case-fatality after myocardial infarction among Mexican Americans and women than among non-Hispanic whites and men. The Corpus Christi Heart Project. , 1994, American journal of epidemiology.

[8]  P. Sorlie,et al.  Mortality by Hispanic status in the United States. , 1993, JAMA.

[9]  J. Mclaughlin,et al.  Comparability of the death certificate and the 1986 National Mortality Followback Survey. , 1993, Vital and health statistics. Series 2, Data evaluation and methods research.

[10]  J E Keil,et al.  Socioeconomic factors and cardiovascular disease: a review of the literature. , 1993, Circulation.

[11]  P. Sorlie,et al.  Validity of demographic characteristics on the death certificate. , 1992, Epidemiology.

[12]  E. Perez-stable,et al.  Prevalence of Diabetes in Mexican Americans, Cubans, and Puerto Ricans From the Hispanic Health and Nutrition Examination Survey, 1982–1984 , 1991, Diabetes Care.

[13]  S. Haffner,et al.  Increased Incidence of Type II Diabetes Mellitus in Mexican Americans , 1991, Diabetes Care.

[14]  E. Ginzberg.  Access to health care for Hispanics. , 1991, JAMA.

[15]  S. Haffner,et al.  Decreased prevalence of hypertension in Mexican-Americans. , 1990, Hypertension.

[16]  R. Hamman,et al.  Methods and prevalence of non-insulin-dependent diabetes mellitus in a biethnic Colorado population. The San Luis Valley Diabetes Study. , 1989, American journal of epidemiology.

[17]  S Wing,et al.  Social inequalities in the decline of coronary mortality. , 1988, American journal of public health.

[18]  S Wing,et al.  Socioenvironmental characteristics associated with the onset of decline of ischemic heart disease mortality in the United States. , 1988, American journal of public health.

[19]  J. Cutler,et al.  The 1988 report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. , 1988, Archives of internal medicine.

[20]  M. Stern,et al.  Secular decline in death rates due to ischemic heart disease in Mexican Americans and non-Hispanic whites in Texas, 1970-1980. , 1987, Circulation.

[21]  S. Haffner,et al.  Hyperinsulinemia in a population at high risk for non-insulin-dependent diabetes mellitus. , 1986, The New England journal of medicine.

[22]  J. C. Kleinman.  State trends in infant mortality, 1968-83. , 1986, American journal of public health.

[23]  S. Haffner,et al.  Prevalence, detection, and control of hypertension in a biethnic community. The San Antonio Heart Study. , 1985, American journal of epidemiology.

[24]  M Rosenthal,et al.  Sex difference in the effects of sociocultural status on diabetes and cardiovascular risk factors in Mexican Americans. The San Antonio Heart Study. , 1984, American journal of epidemiology.

[25]  W. Grove.  Statistical Methods for Rates and Proportions, 2nd ed , 1981 .

[26]  S. Gaskill,et al.  Cardiovascular risk factors in Mexican Americans in Laredo, Texas. I. Prevalence of overweight and diabetes and distributions of serum lipids. , 1981, American journal of epidemiology.

[27]  M. Stern,et al.  Secular Trends in Ischemic Heart Disease and Stroke Mortality from 1970 to 1976 in Spanish-surnamed and Other White Individuals in Bexar County, Texas , 1978, Circulation.

[28]  W. Haskell,et al.  Affluence and cardiovascular risk factors in Mexican-Americans and other whites in three northern California communities. , 1975, Journal of chronic diseases.

[29]  J. Grotta,et al.  African Americans and women have the highest stroke mortality in Texas. , 1997, Stroke.

[30]  David R. Williams,et al.  Us socioeconomic and racial differences in health: patterns and explanations , 1995 .

[31]  D. Labarthe,et al.  Acute myocardial infarction and coronary heart disease mortality among Mexican Americans and non-Hispanic whites in Texas, 1980 through 1989. , 1993, Ethnicity & disease.

[32]  M. Rewers,et al.  Is the risk of coronary heart disease lower in Hispanics than in non-Hispanic whites? The San Luis Valley Diabetes Study. , 1993, Ethnicity & disease.

[33]  S. Haffner,et al.  Level of control of hypertension in Mexican Americans and non-Hispanic whites. , 1993, Hypertension.

[34]  D. Labarthe,et al.  Mortality after hospitalization for myocardial infarction among Mexican Americans and non-Hispanic whites: the Corpus Christi Heart Project. , 1993, Ethnicity & disease.

[35]  S. Haffner,et al.  Eight-year incidence of hypertension in Mexican-Americans and non-Hispanic whites. The San Antonio Heart Study. , 1992, American journal of hypertension.

[36]  S. Haffner,et al.  Myocardial infarction in Mexican-Americans and non-Hispanic whites. The San Antonio Heart Study. , 1991, Circulation.

[37]  R. Hamman,et al.  Cardiovascular risk factors and impaired glucose tolerance: the San Luis Valley Diabetes Study. , 1990, American journal of epidemiology.

[38]  M. Stern,et al.  Special health problems of Mexican-Americans: obesity, gallbladder disease, diabetes mellitus, and cardiovascular disease. , 1989, Advances in internal medicine.

[39]  K. Markides,et al.  The health of Hispanics in the southwestern United States: an epidemiologic paradox. , 1986, Public health reports.

[40]  R. Schoen,et al.  Mortality by cause among Spanish surnamed Californians, 1969-71. , 1981, Social science quarterly.

[41]  S. Steiner.  The Mexican Americans , 1979 .