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Nearly half of all African American adults have some form of cardiovascular disease, and they are twice as likely as Whites to have a stroke, according to a report from the American Heart Association.

The researchers used data from the Jackson Heart Study, which included more than 5,000 African American participants, including 3,360 women, aged 21-94 in the Jackson, Miss. area and followed them for up to ten years.

They discovered that women in the lowest socioeconomic group had more than twice the risk of experiencing a cardiovascular disease event than those in the highest group. Also, men and women age 50 years or younger in the lowest socioeconomic group had more than three times the risk of experiencing a cardiovascular disease event than those in the highest group. During that time, 362 new or repeated cardiovascular “events”—or problems—were recorded in the study group.

Participants’ socioeconomic status was assessed in both adulthood and childhood. The researchers looked at factors such as income, education, wealth and public assistance. For each measure, they divided the study population into thirds by defining low, medium and high. They also adjusted for cardiovascular disease behavioral and health risk factors: smoking, alcohol use, physical activity, body mass index, type 2 diabetes, hypertension, cholesterol and triglycerides.

After adjusting results to account for age, smoking, weight, exercise levels and other chronic health conditions, wealth remained a significant predictor of cardiovascular events in women. Those in the lowest third were 68 percent more likely to experience a cardiovascular disease event than those in the top third, and those in the middle third were 61 percent more likely to experience a cardiovascular disease event than those in the top third.

Family income during childhood wasn’t linked to later-life cardiovascular risks, according to the study.

“Our findings underscore the need for increased awareness and education about prevention and early detection and treatment of cardiovascular disease in African American women and younger adults of low socioeconomic status,” Samson Y. Gebreab, lead study author and research scientist at the National Human Genome Research Institute, Bethesda, Md. said in a statement.

“This is especially true because African Americans generally have less access to health care and are less likely to undertake routine physical examination, despite their increased risk for cardiovascular disease.”

Researchers also analyzed participants’ childhood socioeconomic status by asking them to recall their parents’ education, home ownership and household amenities, but they didn’t find a link between that status and future cardiovascular disease risks.

“Our results may simply reflect a limitation of our study,” Gebreab said. “However, we also think that traditional measures of childhood socioeconomic status may not accurately reflect the childhood social environments of African Americans, which is quite different from that of U.S. Whites because of the history of racial discrimination and segregation. We believe that those factors should also be explored to better understand the life-course contribution to CVD risk in African Americans.”