Young Black Adults Experienced Rising Burden of CVD Risk Factors, Worse Hospital Outcomes in 10-year Study

AHA Scientific Sessions 2021

AHA Scientific Sessions 2021: National study of over 2.9 million young Black adults showed increased rates of CVD risk factors and worsened hospital outcomes between 2007 and 2017.

Image: ©goodluz/
Image: ©goodluz/

Young hospitalized Black adults in the US experienced an increasing burden of cardiovascular disease (CVD) risk factors and worsened in-hospital outcomes between 2007 and 2017, according to preliminary research being presented at the American Heart Association’s (AHA) Scientific Sessions 2021, held virtually from November 13-15, 2021.

Researchers led by Ankit Vyas, MD, an internal medicine resident at the Baptist Hospitals of Southeast Texas, aimed to compare over 10 years the burden of CVD risk factors and major adverse cardiac events and in-hospital outcomes among young hospitalized Black adults aged 18 to 44 years.

Hospitalizations among young Black adults were identified using The National Inpatient Sample databases in 2007 and 2017. Researchers compared the records of more than 2.9 million (mean age 31 years; 70.3% women) young Black adults (n=1 341 068 in 2007; n=1 581 675 in 2017).

Compared to the 2007 arm, participants in the 2017 cohort were younger (mean age, 30 years vs 31 years, respectively), male (30.4% vs 28.8%), and had higher non-elective/emergency hospital admissions (76.8% vs 75%) (p<.001), according to the study abstract.

Participants in the 2017 group, compared to the 2007 cohort, were also more likely to have type 2 diabetes with chronic complications (5.4% vs 1.7%), obesity (16.6% vs 8.1%), and to smoke tobacco (27.4% vs 13.3%).

Also, the 2017 cohort showed a rising burden of traditional cardiometabolic comorbidities, congestive heart failure, chronic pulmonary disease, coagulopathy, depression, as well as notable decreases in alcohol and drug abuse compared with the 2007 cohort.

“Many potential factors seem to be responsible for these findings, including less frequent annual wellness visits; absent or insufficient screening measures at a younger age; genetics; stress; an unhealthy diet; a lack of awareness or insight into a healthy lifestyle; and even financial constraints,” said Vyas in an AHA press release.

Results showed an approximate 20% increase in the risk of major adverse cardiac events among young, Black adults from 2007-2017, including a:

  • 150% increased risk of out-of-hospital cardiac arrest;
  • 200% increased risk of cardiogenic shock;
  • 90% increased risk of pulmonary embolism;
  • 50% increased risk of stroke; and
  • 30% increased risk of myocardial infarction and heart rhythm disturbances.

In an adjusted multivariable analysis, researchers found worsening in-hospital outcomes among the 2017 cohort vs the 2007 group, including major adverse cardiovascular events (adjusted odds ratio [aOR], 1.21), acute myocardial infarction (aOR, 1.34), cardiogenic shock (aOR, 3.12), atrial fibrillation/flutter (aOR 1.34), ventricular fibrillation/flutter (aOR, 1.32), cardiac arrest (aOR, 2.55), pulmonary embolism (aOR, 1.89), and stroke (aOR, 1.53).

Investigators noted in the abstract that the 2017 cohort demonstrated a decreased rate of percutaneous coronary intervention/coronary artery bypass grafting and all-cause mortality compared with 2007 (p<.001).

“Young, Black adults should be encouraged to have regular primary care visits and get annual wellness checkups so any health abnormalities may be noticed at earlier stages, before there are serious health consequences such as a heart attack or stroke,” said Vyas. “Young people must also be aware of factors that can cause heart disease and understand that heart disease can lead to disability and premature death. Prevention is an important first step.”

One study limitation the investigators noted was that it was based on data from a population at a specific time and did not include follow-up data, medication history, or lab findings. Also, information about the burden and impact of e-cigarettes and vaping or the use of recreational cannabis on the cardiovascular health of young adults was not included in the analysis.

“Future research is needed to evaluate factors responsible for increased prevalence in smoking, depression and obesity,” concluded Vyas. “We should also explore the impact of substance abuse, sedentary lifestyle and uncontrolled cardiac risk factors on health outcomes among young, Black adults, including all age groups starting in adolescence. It’s important to develop effective strategies to manage risk factors, especially as studies are reporting an increase in unhealthy lifestyle behaviors during the COVID-19 pandemic.”

Reference: Vyas A, Desai R, Went TR, et al. Rising burden of cardiovascular disease risk and major adverse cardiac events in young African American patients: A national analysis of two cohorts 10-years apart (2017 vs. 2007). Abstract (RF40) presented at: AHA Scientific Sessions 2021, held online November 13-15, 2021.

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