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Published on: September 26, 2018
Disparities in cardiovascular disease risk in the United States
1University of Florida Department of Medicine, PO Box 100227, Gainesville, FL 32610 USA. garth.graham@medicine.ufl.edu.
Insights
Racial and ethnic minorities in the U.S. face higher heart disease risks due to untreated risk factors and comorbidities. Addressing these disparities requires healthcare providers to understand unique population needs for better outcomes.
Area of Science:
- Cardiovascular disease epidemiology
- Health disparities research
- Population health management
Background:
- Heart disease risk assessment is crucial given minority population growth in the U.S.
- Minority populations exhibit higher prevalence of unrecognized coronary artery disease risk factors, leading to increased morbidity and mortality.
- Acute Coronary Syndrome (ACS) rates are elevated in minority communities, with higher risks of myocardial infarction (MI), rehospitalization, and death.
Purpose of the Study:
- To review the current science on population-level differences in heart disease risk factors among U.S. racial and ethnic groups.
- To highlight disparities in the recognition, treatment, and outcomes of cardiovascular conditions in minority populations.
- To emphasize the need for culturally competent healthcare to mitigate heart disease disparities.
Main Methods:
- Comprehensive narrative literature review.
- Analysis of population-level data on risk factors, comorbidities, and treatment utilization.
- Examination of disease presentation and prognosis across diverse racial and ethnic groups.
Main Results:
- Minority patients with ACS receive less beneficial treatment like angiography and percutaneous coronary intervention.
- Comorbidities such as hypertension and diabetes mellitus, combined with environmental factors, contribute significantly to heart failure (CHF) disparities.
- Untreated risk factors and comorbidities in minority populations increase the likelihood of adverse cardiovascular outcomes.
Conclusions:
- Healthcare providers must understand the unique attributes of diverse racial and ethnic communities, including disease presentation, risk factors, and treatment nuances.
- Awareness of incidence, risk factor burdens, prognosis, and treatment differences is essential for mitigating racial and ethnic disparities in heart disease.
- Tailored healthcare approaches are necessary to address the specific needs of minority populations and reduce cardiovascular health inequities.
Abstract:
This is a comprehensive narrative review of the literature on the current science and evidence of population-level differences in risk factors for heart disease among different racial and ethnic population in the United States (U.S.). It begins by discussing the importance of population-level risk assessment of heart disease in light of the growth rate of specific minority populations in the U.S. It describes the population-level dynamics for racial and ethnic minorities: a higher overall prevalence of risk factors for coronary artery disease that are unrecognized and therefore not treated, which increases their likelihood of experiencing adverse outcome and, therefore, potentially higher morbidity and mortality. It discusses the rate of Acute Coronary Syndrome (ACS) in minority communities. Minority patients with ACS are at greater risk of myocardial infarction (MI), rehospitalization, and death from ACS. They also are less likely than non-minority patients to receive potentially beneficial treatments such as angiography or percutaneous coronary intervention. This paper looks at the data surrounding the increased rate of heart disease in racial and ethnic minorities, where the risk is related to the prevalence of comorbidities with hypertension or diabetes mellitus, which, in combination with environmental factors, may largely explain CHF disparity. The conclusion is that it is essential that healthcare providers understand these various communities, including nuances in disease presentation, risk factors, and treatment among different racial and ethnic groups. Awareness of these communities' attributes, as well as differences in incidence, risk factor burdens, prognosis and treatment are necessary to mitigate racial and ethnic disparities in heart disease.
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