Black adults had the highest rates of obesity-related cardiovascular disease deaths between 1999 and 2020, and the highest percentage was found in Black women, according to a new study published in the Journal of the American Heart Association .
Research Highlights:
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Summary
Background
Obesity is an important risk factor for cardiovascular disease, with differential impact between populations. This descriptive epidemiological study describes trends and disparities in obesity-related cardiovascular mortality in the US population between 1999 and 2020.
Methods and results
The multiple causes of death database was used to identify adults with primary cardiovascular death and obesity recorded as a contributing cause of death. Cardiovascular deaths were grouped into ischemic heart disease, heart failure, hypertensive disease, cerebrovascular disease and others . Absolute, crude, and age-adjusted mortality rates (AAMR) were calculated by racial group, considering temporal trends and variation by sex, age, and residence (urban versus rural).
Analysis of 281,135 obesity-related cardiovascular deaths demonstrated a three-fold increase in crude and age-adjusted rates (AAMR) between 1999 and 2020 (2.2 to 6.6 per 100,000 population). Black individuals had the highest AAMR. American Indians/Alaska Natives had the largest temporal increase in AAMR (+415%).
Ischemic heart disease was the most common primary cause of death. The second most common cause of death was hypertensive disease , which was most common in the black racial group (31%). Among blacks, women had higher AAMR than men; In all other racial groups, men had a higher proportion of obesity-related cardiovascular mortality and higher AAMRs. Blacks had higher AAMR in urban compared to rural settings; In all other races the opposite was observed.
Conclusions
Obesity-related cardiovascular mortality is increasing with differential trends by race, sex, and place of residence.
Comments
The number of deaths from obesity-related heart disease has recently tripled in the U.S. between 1999 and 2020, according to new research published in the Journal of the American Heart Association , an open access, peer-reviewed journal. the American Heart Association.
“The number of people with obesity is increasing in all countries of the world. “Our study is the first to show that this growing burden of obesity is translating into increased deaths from heart disease,” said senior study author and cardiologist Zahra Raisi-Estabragh, MD, clinical professor at the William Research Institute. Harvey from London. "This growing obesity trend is affecting some populations more than others, particularly black women."
Obesity remains a global public health crisis and is a major risk factor for cardiovascular disease. It currently affects about 42% of the U.S. population, an increase of nearly 10% from the previous decade, according to 2023 statistics from the American Heart Association.
The researchers looked at race, gender, and urban versus rural settings to determine differences in deaths from heart disease in which obesity was listed as a contributing factor.
Among the findings:
- Overall, deaths from obesity-related cardiovascular diseases tripled from 2.2 per 100,000 inhabitants to 6.6 per 100,000 inhabitants between 1999 and 2020.
- Deaths from obesity-related cardiovascular disease were higher among blacks compared to any other racial group, at 6.7 per 100,000 population; followed by American Indian or Alaska Native adults at 3.8 per 100,000.
- Black women had the highest rates of obesity-related heart disease deaths than anyone else in the study. In other racial groups, men experienced more deaths from obesity-related heart disease than women.
Black adults living in urban areas had higher rates of obesity-related heart disease deaths compared with Black adults living in rural areas (6.8 vs. 5.9 per 100,000), while rural living was associated with higher rates of obesity-related cardiac deaths in all people of other racial groups.
"The trend of higher obesity-related cardiovascular mortality rates for black women than for men was striking and different from all other racial groups considered in our study," said lead author Mamas A. Mamas, MD, D. .Phil. Professor of Cardiovascular Medicine at Keele University in Keele, United Kingdom.
Additionally, Raisi-Estaugh noted that Black people living in urban communities may be more affected by socioeconomic deprivation and health inequalities than Black people living in rural areas, and who did not benefit from greater access to care. medical treatment that appears to benefit people of other racial groups living in urban areas.
Study details and background:
- The researchers analyzed data collected between 1999 and 2020 on 281,135 deaths in which obesity was recorded as a contributing factor in the Multiple Causes of Death database that includes mortality and population counts for all US counties.
- Among the deaths, 43.6% were women; 78.1% of the group were white adults; 19.8% were black adults; 1.1% were Asian or Pacific Islander adults and 1% were American Indian or Alaska Native adults.
The researchers note that coding and data entry errors may be a limitation of the findings, since the source was electronic medical records whose accuracy the researchers could not verify. However, the results still underscore the need to address obesity more effectively in individuals and communities.
What are the clinical implications?
- The impact of obesity on cardiovascular health is increasing and some groups are more affected than others.
- The observed population disparities provide information for the implementation of effective prevention strategies at both the population and individual levels.
- Such interventions should incorporate strategies to address the sociopolitical sources of health inequalities in individual communities with the goal of alleviating the burden of obesity and cardiovascular disease.
