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Valvular Heart Disease in Relation to Race and Ethnicity: JACC Focus Seminar 4/9
Julio A Lamprea-Montealegre1, Shakirat Oyetunji2, Rodrigo Bagur3
1Division of Cardiology and Kidney Health Research Collaborative, University of California-San Francisco, San Francisco, California, USA.
Insights
Valvular heart disease (VHD) affects global health, with disparities in diagnosis and treatment linked to race and ethnicity. Research must address these inequities for better patient outcomes.
Area of Science:
- Cardiology
- Public Health
- Health Disparities
Background:
- Valvular heart disease (VHD) presents a significant global health challenge.
- Rheumatic heart disease (RHD) impacts low-resource regions, while calcific VHD rises in aging populations of middle- and high-income countries.
- Infective endocarditis further exacerbates VHD's morbidity and mortality.
Purpose of the Study:
- To review VHD etiology, diagnosis, and treatment.
- To examine VHD within the context of race, ethnicity, and healthcare disparities.
- To highlight the need for equitable VHD research and care.
Main Methods:
- Literature review of existing studies on VHD.
- Analysis of VHD prevalence and outcomes across different racial and ethnic groups.
- Examination of healthcare access and treatment disparities.
Main Results:
- Significant healthcare disparities exist in VHD risk factors, diagnosis, and treatment based on race and ethnicity.
- Race and ethnicity are not sufficiently prioritized in current VHD research.
- Existing evidence points to socioeconomic and medical factors contributing to these disparities.
Conclusions:
- Addressing race and ethnicity is crucial for understanding and mitigating VHD.
- Equitable access to diagnosis and treatment is essential for managing VHD globally.
- Further research is needed to eliminate healthcare disparities in VHD care.
Abstract:
Valvular heart disease (VHD) is a major global public health problem. Many regions of the world continue to grapple with the adverse consequences of untreated rheumatic heart disease, a condition that is largely preventable with timely access to diagnosis and treatment. In turn, middle- and high-income countries have experienced a rise in the prevalence of calcific aortic and mitral disease, owing in part to population aging. This public health problem is further compounded by high rates of infective endocarditis, which is associated with substantial morbidity and mortality. Yet, considerations of race and ethnicity have not taken center stage in VHD research. This is despite evidence of major health care disparities in socioeconomic and medical risk factors, access to diagnosis, and provision of appropriate treatment. In this paper, the authors review differences in the etiology, diagnosis, and treatment of VHD within the context of race, ethnicity, and health care disparities.
