Racial and ethnic differences in cardiovascular disease risk factors: A systematic review

Objective: This systematic review was undertaken to expand our understanding of the factors associated with racial/ethnic disparities in cardiovascular disease (CVD) risk factors (hypertension, diabetes, obesity, hypercholesterolemia, no leisure-time physical activity, and smoking), to assess the potential differences in the CVD risk factors by race/ethnicity, and to update and expand on existing reviews. Methods: English-language, population-based CVD studies published between 1995 to present, which included one or more ethnic comparison in an adult population were reviewed. Results: Sixteen studies were included in this review. Most of the studies found hypertension to be significantly higher in Blacks than Whites. Minority status was also significantly associated with diabetes. No one racial/ethnic minority population was consistently found to have a higher or lower prevalence of obesity or hypercholesterolemia. Mexican Americans had a significantly lower prevalence of smoking than Whites and Blacks; American Indian/Alaskan Natives (AIANs) had significantly higher prevalence of smoking compared to Whites. Mexican Americans had the highest prevalence of no leisure-time physical activity, followed by AIANs and Blacks. Conclusion: Cardiovascular diseases are the leading cause of death in the United States, and disproportionate rates are seen in racial and ethnic minority populations. Systematically assessing and quantifying modifiable CVD risk factors is therefore crucial in these populations. Better understanding and awareness of the disparities of CVD risk factors by race and ethnicity may help clinicians and public health professionals develop culturally sensitive interventions, prevention programs, and services specifically targeted toward risk burdens in each of these populations.