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Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
Published on: January 28, 2020
Inflammatory biomarkers, race/ethnicity and cardiovascular disease
1Harvard Medical School, Brigham and Women's Hospital, Division of Cardiovascular and Preventive Medicine, Boston, Massachusetts 02115, USA. maalbert@partners.org
Insights
Cardiovascular disease (CVD) disparities persist among racial/ethnic groups in the US. Understanding these differences requires addressing barriers to research participation for minority populations.
Area of Science:
- Public Health
- Cardiology
- Health Disparities
Background:
- Cardiovascular disease (CVD) is a leading cause of death in developed nations, with significant costs.
- Racial and ethnic disparities in CVD morbidity and mortality are evident in the US, with African Americans experiencing the highest death rates.
- Current CVD risk reduction strategies, like hyperlipidemia screening, are insufficient for identifying all high-risk individuals.
Purpose of the Study:
- To highlight the need for research into the multifactorial basis of racial/ethnic disparities in CVD.
- To emphasize the importance of inflammation and thrombosis markers in CVD risk assessment across diverse populations.
- To identify and address barriers hindering ethnic minority participation in cardiovascular research.
Main Methods:
- Review of existing literature on CVD, racial/ethnic disparities, and risk markers.
- Analysis of data on hyperlipidemia screening effectiveness and limitations.
- Identification of barriers to research participation for ethnic minority groups.
Main Results:
- Hyperlipidemia treatment, while effective, does not identify all individuals at high CVD risk.
- Inflammation and thrombosis markers (e.g., hs-CRP, homocysteine) are associated with CVD risk, but data across racial/ethnic groups are limited.
- Significant barriers impede the inclusion of ethnic minorities in US-based research studies.
Conclusions:
- Addressing racial/ethnic disparities in CVD requires a deeper understanding of underlying biological and social factors.
- Further research is crucial to validate CVD risk markers across diverse populations.
- Overcoming barriers to research participation is essential for achieving health equity in cardiovascular disease prevention and treatment.
Abstract:
Cardiovascular disease (CVD) remains the leading cause of death in the developed world. In the United States alone, cardiovascular disease accounts for nearly 40% of deaths, at an estimated annual cost of at least US $430 billion. Notable, racial/ethnic differences in morbidity and mortality have been observed; in the United States, African Americans have the highest age-adjusted death rate from CVD, followed by Whites, Hispanics, and Asians. The underlying basis for the observed racial/ethnic disparities in CVD morbidity and mortality is likely multifactorial. Although hyperlipidemia screening and treatment has proven to be one of the most effective strategies for reducing CVD burden in the US population, it often fails to identify a substantial proportion of persons at high risk for CVD-related events. Elevations in markers of inflammation and thrombosis such as high sensitivity C-reactive protein, soluble intercellular adhesion molecule, homocysteine, and fibrinogen are also associated with increased CVD risk. However, data relating markers of inflammation and hemostasis to CVD principally come from White populations, little data are available across racial/ethnic groups. A range of barriers exist related to ethnic minority subject participation in research studies in the United States. If we are to better understand the racial differences in cardiovascular risk, these barriers must be overcome.
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