Deaths from heart-related causes have dropped over the past 20 years, though differences persist by race and ethnicity as well as where people live and their access to care.
The U.S. National Institutes of Health (NIH), which partially funded the research, detailed the results of three papers. The findings were published July 18 in the American Heart Association journal Circulation.
One study used data from the U.S. Centers for Disease Control and Prevention, finding that death rates linked to heart disease dropped between 1999 and 2019 for both Black and white adults.
While gaps between the two groups lessened, Black adults continued to have higher death rates than white adults. This was especially true in rural or segregated areas and among younger Black adults.
"The persistent disparities observed in our study likely reflect the fact that Black adults disproportionately experience social, economic and environmental barriers to optimal health due to systemic inequities and structural racism," co-author Dr. Rishi Wadhera said in an NIH news release. He's an assistant professor at Harvard Medical School.
Initiatives in Black communities to expand access to heart disease risk screenings, prevention and care, including blood pressure screenings at barbershops, have helped to close the gaps, researchers said.
In a second study, researchers with the Multi-Ethnic Study of Atherosclerosis (MESA) described similar associations.
For that study, MESA followed more than 6,800 adults for 15 years. About 20% died during that time. Of those, 25% were from heart-related causes.
The study found that Black adults had a 34% greater overall risk death during the follow-up compared to white adults.
Factors such as a person's income, neighborhood, education level and access to health care were independent predictors for premature death. After adjusting for those factors, researchers found that Black adults had a 16% greater risk of death.
Hispanic participants and Asian Americans had the lowest overall risk for early death, though that trend was partly reversed when researchers accounted for immigration history. Living for a shorter time in the United States was protective. It wasn't clear whether that was because these participants started out healthier or if it was due to having less time to adapt to an unhealthy American lifestyle.
"In addition to assessing traditional risk factors for heart disease, such as diabetes, family history, blood pressure, cholesterol and smoking, this research shows the importance of identifying and accounting for social determinants of health when calculating risk," said study co-author Dr. Wendy Post, director of cardiovascular research at Johns Hopkins University School of Medicine in Baltimore.
"More importantly, we must identify systemic factors in our society that can be altered to improve these longstanding inequities," she said in the release.
The third paper reported an increase in heart deaths related to heat among U.S. adults during summers from 2008 through 2017.
Older adults, men and Black adults were most likely to die of heart-related causes when the temperature hit or topped 90 degrees. Potential remedies might include increasing access to shade or cooling centers in affected communities, the authors said.
"Multiple factors can independently and synergistically influence cardiovascular health," said Dr. Nicole Redmond of the Division of Cardiovascular Sciences at the U.S. National Heart, Lung, and Blood Institute.
"Further study of the intersection of environmental, social, behavioral and clinical risk factors and potential interventions are needed to mitigate these risks and close the equity gap," she said.
The American Heart Association has more on heart and blood vessel disease.
SOURCE: U.S. National Institutes of Health, news release, July 18, 2022