Heart research bias puts Black, Hispanic women at risk

Earlier disease onset for Black and Hispanic women points to "weathering" or earlier health declines in these groups due to structural social and economic marginalization. (Credit: Getty Images)

Black and Hispanic women experience cardiometabolic risks five to 11 years earlier than white women, but studies often underestimate the disparity, new research shows.

These biases concerning heart disease and metabolic disorder put the lives of women in midlife in jeopardy, the researchers say.

In the study published in JAMA Network Open, researchers corrected for the sources of systematic exclusion common in studies and learned that correction for these biases decreased the estimated age of cardiometabolic disease onset by an average of 20 years.

“Black and Hispanic women were most affected by these biases,” says lead author Alexis Reeves, a former doctoral student in epidemiology at the University of Michigan’s School of Public Health.

Earlier disease onset for minority populations points to “weathering” or earlier health declines in these groups due to structural social and economic marginalization.

Given that cardiometabolic diseases are the main predictor of health and longevity, understanding these racial differences in “weathering” and the typical age of onset of the disease is important to target interventions to earlier stages of life for prevention, says senior author Sioban Harlow, professor of epidemiology.

The study data are from a cohort study that followed midlife women from 1996 to 2016. The study included more than 3,300 women ages 42 to 52 years in 1996, whose racial or ethnic group included Black, Chinese, Hispanic, Japanese, and white women.

The findings indicate that hypertension occurred about five years earlier and insulin resistance and diabetes 11 years earlier for minority women compared to their white counterparts.

“Failure to account for selection biases… was associated with falsely high estimates of age at cardiometabolic onset, with greater misestimation among Black and Hispanic women,” says Reeves, who is currently a postdoctoral fellow at Stanford University School of Medicine.

In other words, interventions should be targeted to minority women as young as 30 years for hypertension and 40 years for metabolic conditions, Reeves says. If not addressed, cardiometabolic disease will shorten a person’s life span.

She notes the study had limited power for estimating age of onset for Chinese and Japanese women, as they had a low prevalence and incidence of metabolic outcomes in the study.

The study highlights important and understudied biases in observational research, Reeves says, and suggests the need for more careful consideration of these biases in new and ongoing research on the causes and prevention of earlier aging and health declines for minority populations.

Additional coauthors are from Emory University and the University of Michigan.

Source: University of Michigan