The Multiple Risk Factor Intervention Trial screening program provided an opportunity (1) to study the association of diastolic blood pressure level, serum cholesterol concentration, and cigarettes per day with all-cause and cause-specific mortality after 5 years among 23,490 black males and (2) to compare these associations with those observed among 325,384 white males. The relationship of serum cholesterol concentration and reported cigarettes per day to all-cause, coronary heart disease (CHD), and cerebrovascular disease mortality was similar for black and white males. Diastolic blood pressure was more positively associated with cerebrovascular disease death among black males than white males (p = 0.047) according to logistic regression analysis. The lower CHD mortality among black males compared to white males was most apparent among hypertensive males (diastolic blood pressure ≥90 mm Hg). The relative risk (black vs white) of CHD death adjusted for age, serum cholesterol concentration, and cigarettes per day was 0.69 for hypertensive males compared to 1.15 for nonhypertensive males (p = 0.012 for difference in relative risk estimates). These findings suggest that the causes of CHD and cerebrovascular disease may be different for black and white males, particularly in regard to how these disease processes relate to blood pressure.
Bibliographical noteFunding Information:
From the Division of Biometry, University of Minnesota School of Public Health, Minneapolis, the Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, and the Depart-merit of Community Health, School of Medicine, University of California, Davis. Supported by National Institutes of Health grant No. l-ROl-HL28715-01. Reprint requests: James D. Neaton, M.S., 2829 University Ave. S.E., Suite 508, Minneapolis, MN 55414. ‘For the Multiple Risk Factor Intervention