NEW YORK (Reuters) -- The risk of coronary heart disease is higher among black women between the ages of 25 to 54 years old than it is for white women in the same age group, researchers say. But the situation reverses for women between the ages of 65 to 74: in this age group, a Centers for Disease Control and Prevention (CDC) study found that African-American women "had a significantly lower risk for coronary heart disease than white women, after controlling for multiple risk factors."

The government study also found that the heart disease risk among black men ages 25 to 74 is lower than it is for whites. And the study found no difference overall between blacks and whites in survival after a first-time hospitalization for coronary problems, including chest pains and heart attack.

In light of the higher rate of heart disease in black women under age 65, CDC researchers are urging doctors to work with this group to reduce heart disease risk factors such as high blood pressure, diabetes, and cigarette smoking.

"Relatively few data are available on risk for or survival with coronary heart disease in African-American persons," say researchers led by Dr. Richard Gillum of the CDC's Office of Analysis, Epidemiology, and Health Promotion.

The researchers note that blacks, compared with whites, have higher rates of death from heart disease at younger ages, and lower rates after middle age. "This makes examination of data within age groups very important," they write in the Annals of Internal Medicine.

Gillum and his colleagues analyzed follow-up data from the National Health and Nutrition Examination Survey (NHANES). The survey included 11,406 people ages 25 to 74 years who had no history of coronary heart disease when the study began. Average follow-up time was 19 years.

The risk for developing heart disease among black women ages 25 to 54 years was 1.76 times that of their white counterparts. For all ages combined, black men had a 35% lower risk of heart disease and a 38% lower likelihood of heart attack.

"The increased risk in African-American women could be explained statistically by their higher risk factor levels," the researchers say.

They point out that heart-protective factors such as higher levels of high density lipoprotein (HDL) cholesterol among blacks 20 years ago helped reduce the risk of heart disease and heart attacks, resulting in lower national rates of death from these problems.

"However, the rapid adoption of unhealthful lifestyles since the 1960s and slower adoption of heart healthy behaviors in the 1970s and 1980s by African-American persons may have caused an almost complete loss of this protection in African-American women and a partial loss in African-American men by the 1990s," the researchers explain.

"On the basis of these findings, clinicians should vigorously work to reduce the high levels of cardiovascular risk factors in African-American women younger than age 65," they conclude.

SOURCE: Annals of Internal Medicine (1997;127:111-118)