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Ethn Dis. 2006 Winter;16(1):152-8.

Effect of race category redefinition on hypertension and hypercholesterolemia prevalence in the behavioral risk factor surveillance system, 1999 and 2001.

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  • 1Behavioral Risk Factor Surveillance System, Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.


Race information in the United States is used to identify populations at risk for cardiovascular disease (CVD) or associated risk factors. Behavioral Risk Factor Surveillance System data from 1999 and 2001 were used to examine shifts in racial distributions and CVD risk factors after a multiracial category was added in 2001. We compared age-adjusted, weighted, race-specific prevalence estimates of self-reported high blood pressure (HBP) and high blood cholesterol (HBC) from 1999 and 2001 with descriptive statistics and 95% confidence intervals. The proportion of non-Hispanic Whites decreased significantly after the multiracial category was added. Overall, the prevalence of HBC did not significantly change, but HBP increased significantly, from 24.2% in 1999 to 25.6% in 2001 (P<.05). Among racial groups, only non-Hispanic Whites showed a statistically significant increase in HBP prevalence from 23.1% to 24.4% (P<.05); however, larger percentage increases in HBP were seen among non-Hispanic Asian/Pacific Islanders (3.5%) and non-Hispanic Blacks (1.6%). Among non-Hispanic Whites, when combining multiracial respondents whose preferred single race was non-Hispanic White, the prevalence of HBP was significantly higher in 2001 than in 1999. The race-specific prevalence of HBP and HBC was virtually unchanged, whether or not multiracial respondents were included in prevalence estimates. Observed HBP increases for non-Hispanic Whites were not caused by the addition of a multiracial category. In 2001, multiracial respondents had the second highest prevalence of HBP after non-Hispanic Blacks. To promote heart health, we must focus on the needs of this emerging multiracial group and on groups with increasing rates of HBP.

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