{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T04:49:51Z","timestamp":1789102191273,"version":"build-2803163510"},"reference-count":70,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2025,3,26]],"date-time":"2025-03-26T00:00:00Z","timestamp":1742947200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec010\">\n<jats:title>Objective<\/jats:title>\n<jats:p>To explore the association between ethnicity and cardiovascular disease (CVD) risk factors, including physical inactivity, obesity, hypertension, type 2 diabetes (T2D), lack of health insurance and low family income in a nationally representative sample of U.S. adults.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec011\">\n<jats:title>Research design and methods<\/jats:title>\n<jats:p>Adults from the National Health and Nutrition Examination Survey (NHANES 2011-2020, n\u2009=\u200917,355) were classified as having CVD risk factors based on both self-reported and metabolic data. Ethnic differences in how these CVD risk factors relate to prevalent CVD and CVD mortality was examined in Whites, Blacks, Asians and Hispanics.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec012\">\n<jats:title>Results<\/jats:title>\n<jats:p>Compared to Whites, significant disparities were noted in several CVD risk factors in ethnic minorities, such as lower PA, lower income, and more prevalent metabolic risk factors. Blacks and Hispanics commonly had higher prevalent CVD risk as compared to Whites even after adjusting for income and metabolic risk factors. Physical inactivity was most strongly associated with prevalent CVD and CVD mortality among Whites and Blacks. There were no ethnic differences in the inverse association between income and prevalent CVD risk, but Blacks with low income were associated with the greatest elevated CVD mortality. Hypertension and T2D were similarly related with prevalent CVD across ethnic groups, but Blacks and Hispanics with hypertension or T2D were at greater CVD mortality risk as compared to Whites.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec013\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Our study identified that socioeconomic and metabolic risk factors may relate differently to CVD outcomes among ethnic minority groups in the United States. Addressing these ethnic disparities in health warrants further investigation.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0319617","type":"journal-article","created":{"date-parts":[[2025,3,26]],"date-time":"2025-03-26T19:25:15Z","timestamp":1743017115000},"page":"e0319617","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":12,"title":["Ethnic variations in cardiovascular disease (CVD) risk factors and associations with prevalent CVD and CVD mortality in the United States"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-0403-5577","authenticated-orcid":true,"given":"Queenie","family":"Cheung","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"Wharton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Josse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3425-6149","authenticated-orcid":true,"given":"Jennifer L.","family":"Kuk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,3,26]]},"reference":[{"key":"pone.0319617.ref001","doi-asserted-by":"crossref","first-page":"2361","DOI":"10.1016\/j.jacc.2022.11.005","article-title":"The global burden of cardiovascular diseases and risk","volume":"80","author":"M Vaduganathan","year":"2022","journal-title":"J Am Coll Cardiol"},{"issue":"2","key":"pone.0319617.ref002","doi-asserted-by":"crossref","first-page":"88","DOI":"10.5455\/msm.2023.35.88-93","article-title":"Public health dimensions of CVD prevention and control - global perspectives and current situation in the federation of BiH","volume":"35","author":"A Ramic-Catak","year":"2023","journal-title":"Mater Sociomed"},{"issue":"8","key":"pone.0319617.ref003","first-page":"e153","article-title":"Heart disease and stroke statistics-2022 update: A report from the American Heart AssociationCirculation","volume":"145","author":"CW Tsao","year":"2022","journal-title":"LWW"},{"key":"pone.0319617.ref004","author":"World Health Organization"},{"issue":"9","key":"pone.0319617.ref005","doi-asserted-by":"crossref","first-page":"e139","DOI":"10.1161\/CIR.0000000000000757","article-title":"Heart disease and stroke statistics-2020 update: A report from the American Heart Association","volume":"141","author":"SS Virani","year":"2020","journal-title":"Circulation"},{"key":"pone.0319617.ref006","author":"Center for Health Statistics N"},{"key":"pone.0319617.ref007","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1186\/s40985-018-0109-4","article-title":"Cardiovascular disease in racial\/ethnic minority populations: Illness burden and overview of community-based interventions","volume":"39","author":"B Muncan","year":"2018","journal-title":"Public Health Rev"},{"issue":"6","key":"pone.0319617.ref008","doi-asserted-by":"crossref","first-page":"1016","DOI":"10.1016\/j.cjca.2024.01.028","article-title":"Racial and ethnic disparities in primary prevention of Cardiovascular Disease","volume":"40","author":"MR Ali","year":"2024","journal-title":"Can J Cardiol"},{"issue":"1","key":"pone.0319617.ref009","first-page":"143","article-title":"Racial and ethnic differences in cardiovascular disease risk factors: A systematic review","volume":"17","author":"AK Kurian","year":"2007","journal-title":"Ethn Dis"},{"key":"pone.0319617.ref010","volume-title":"Understanding Racial and Ethnic Differences in Health in Late Life","year":"2004"},{"issue":"3","key":"pone.0319617.ref011","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1161\/CIRCULATIONAHA.122.059174","article-title":"Racial and ethnic differences in all-cause and cardiovascular disease mortality: The MESA Study","volume":"146","author":"WS Post","year":"2022","journal-title":"Circulation"},{"issue":"1","key":"pone.0319617.ref012","doi-asserted-by":"crossref","first-page":"19475","DOI":"10.1038\/s41598-022-21878-x","article-title":"Racial disparities and prevalence of cardiovascular disease risk factors, cardiometabolic risk factors, and cardiovascular health metrics among US adults: NHANES 2011-2018","volume":"12","author":"SM Lopez-Neyman","year":"2022","journal-title":"Sci Rep"},{"key":"pone.0319617.ref013","unstructured":"Heart Association A. 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