ISCHEMIC-HEART-DISEASE AND STROKE MORTALITY IN AFRICAN-AMERICAN, HISPANIC, AND NON-HISPANIC WHITE MEN AND WOMEN, 1985 TO 1991

We compare recent trends in ischemic heart disease (IHD) and stroke mo rtality in California among the 6 major sex-racial or -ethnic groups. Rates of age-specific and -adjusted mortality were calculated for pers ons aged 35 and older during the years 1985 to 1991. Log-linear regres sion modeling was performed to estimate the average annual percentage change in mortality. During 1985 through 1991, the mortality for IHD a nd stroke was generally highest for African Americans, intermediate fo r non-Hispanic whites, and lowest for Hispanics. Age-adjusted mortalit y for IHD declined significantly in all sex-racial or -ethnic groups e xcept African-American women, and stroke rates declined significantly in all groups except African-American and Hispanic men. African Americ ans had excess IHD mortality relative to non-Hispanic whites until lat e in life, after which mortality of non-Hispanic whites was higher. Si milarly, African Americans and Hispanics had excess stroke mortality r elative to non-Hispanic whites early in life, whereas stroke mortality in non-Hispanic whites was higher at older ages. The lower IHD and st roke mortality among Hispanics was paradoxical, given the generally ad verse risk profile and socioeconomic status observed among Hispanics. An alarmingly high prevalence of self-reported cardiovascular disease risk factors in 1994 to 1996, particularly hypertension, leisure-time sedentary lifestyle, and obesity, is a serious public health concern, with implications for future trends in cardiovascular disease mortalit y. Of particular concern was the growing disparities in stroke and IHD mortality among younger-aged African Americans relative to Hispanics and non-Hispanic whites.