Findings suggest prevention programs should begin early in childhood.
Mexican American and black youth generally have a greater prevalence of heart disease risk factors than white youth, according to an article published in The Journal of the American Medical Association (JAMA).
Marilyn A. Winkleby, Ph.D., M.P.H., and colleagues at the Stanford University School of Medicine in Palo Alto, Calif., studied individuals aged 6 to 24 years old to investigate possible ethnic differences in risk factors for cardiovascular disease (CVD). Home questionnaires and medical examinations were completed for 2,769 black, 2,854 Mexican American and 2,063 white children and young adults. The researchers found some strong ethnic differences in the CVD risk factors among children and youths of comparable age and socioeconomic status.
“The differences highlight the need for heart disease prevention programs to begin early in childhood and continue throughout young adulthood to reduce the risk of atherosclerosis,” according to the authors. The research evaluated the following six CVD risk factors after accounting for household socioeconomic status (SES) and age:
* Body mass index (BMI, a standard measure to determine if a person is overweight or obese; it is a calculation of a person’s weight in kilograms divided by their height in meters squared).
-BMI levels were significantly higher for black and Mexican American girls than for white girls.
* Percentage of energy from dietary fat based on an interview that tried to determine what foods and drinks had been consumed in the last 24 hours.
-Percentage of energy from dietary fat was higher for black and Mexican American girls and black boys than for white girls and boys.
*Current cigarette smoking status.
-Smoking prevalence was significantly higher for white girls and boys.
* Blood pressure (systolic).
-Blood pressure levels were higher for black girls than white girls.
* Glycosylated hemoglobin blood test used as an indicator of the blood glucose concentration during the previous two to three months (glycosylated hemoglobin levels have been related to atherosclerosis in youth and may indicate early stages of diabetes)
-Glycosylated hemoglobin levels were higher for black and Mexican American girls and boys than for white girls and boys.
* Non-HDL-cholesterol levels (the difference between total cholesterol levels and high-density lipoprotein [HDL, "good cholesterol"] levels in the blood)
-There was no significant difference between ethnic groups for non-HDL-cholesterol levels.
Even though cardiovascular diseases do not usually become apparent until adulthood, many of the risk factors (elevated blood pressure, excess weight and abnormalities in cholesterol levels) are present during childhood and continue into adulthood, the authors write. These risk factors are also associated with the presence of atherosclerosis (fatty deposits containing cholesterol that build up in the lining of the arteries) in children and young adults.
“Ethnic differences in CVD risk factors in children are of special importance because of the premature mortality from CVD and high levels of CVD risk factors experienced by adult ethnic minority populations, most notably African American and Mexican American populations, which constitute the two largest minority groups in the United States,” according to the authors.
“Our results suggest that preventive interventions for many CVD risk factors need to start early in childhood and continue throughout adolescence and into adulthood,” the authors write. “The ethnic differences we found in risk factors, including BMI, energy from dietary fat, cigarette smoking, systolic blood pressure and glycosylated hemoglobin, evident as early as 6 to 9 years of age, reinforce the need for early interventions. The focus of attention in youth should be on promoting population-wide, heart-healthy behaviors in both children and their parents through programs at the family, school, community, and public policy levels. Given the increasing diversity of America, it is critical to tailor programs to the culture of youths, their group-specific attitudes, perceptions, expectations, norms and values, and to appropriate languages and literacy levels.”
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