Abstract Body (Do not enter title and authors here):

Background: Cardiovascular (CV) diseases significantly contribute to morbidity and mortality in U.S minority communities. However, sex-related disparities within ethnic groups are underexplored. This study examines sex-related differences in CV risk and risk factors among African, Asian, and Hispanic individuals served at Health Promoters (HPs), a network of free preventive health clinics in Philadelphia.

Methods: This cross-sectional study (July 2023–February 2025) collected biometric and lifestyle data of a total of 498 people at HPs. Data were securely stored in REDCap and included systolic and diastolic blood pressure (SBP, DPB), blood glucose (BG), total cholesterol (TC), waist-to-hip ratio (WHR), BMI, and smoking status. INTERHEART Risk Scores (IRS) were calculated and categorized into low (0–9), moderate (10–15), and high (≥16) risk. Chi-square, one-way ANOVA, and Tukey’s HSD tests were used to assess sex and ethnicity based differences.

Results: Among 274 females, obesity (BMI ≥30) was most common in Africans (60.8%) and Hispanics (46.7%) but much lower in Asians (11.2%). Asian females had significantly lower average BMI than Hispanic females, who in turn had lower BMI than African females (p<0.001). A high WHR ≥ 0.964 was more frequent in African (17.6%) and Hispanic (18.2%) females. Elevated SBP (≥140 mmHg) was most common in African females (30.1%), followed by Asians (22.1%). BG >200 was seen more in Hispanic females (10%) than in African (5.9%) and Asian (4%) females.
Among 224 males, obesity was more frequent in African (41%) and Hispanic (41.4%) males than in Asians (12.4%), and Asian males had a significantly lower average BMI (p<0.001) compared to others. WHR ≥0.964 was most prevalent in African males (34.9%), followed by Asians (34.1%) and Hispanics (32%). Smoking was much less common in African (1.8%) and Asian (11.4%) females than their male counterparts (20.7% and 50%, respectively). IRS ≥16 were most frequent in Hispanic females (36.4%), and more Asian males were in moderate (45.9%) and high risk (30.6%) categories compared to Asian females (34.9% and 16.3%, p=3.16e-04).

Conclusion: Significant sex- and ethnicity-related disparities exist in CV risk profiles. These findings underscore the need for culturally tailored, gender-specific CV prevention strategies in underserved minority populations.