Disease Management and Healthcare Utilization in Limited English Proficiency Patients with Cardiovascular Disease

Despite the high prevalence of cardiovascular disease (CVD), data on CVD management and disease control among patients with limited English proficiency (LEP) are limited. In this study, we sought to understand CVD risk factor control, disease management, and healthcare utilization in LEP patients.

We conducted a retrospective cohort study using the National Health and Nutrition Examination Survey (NHANES) database from 2011 to 2020 in LEP and English-speaking patients diagnosed with coronary artery disease (CAD) or heart failure (HF). We compared medication use, symptom burden, healthcare utilization, and CVD risk factors control based on language preference. We further assessed for significant differences between these groups using multivariable modeling.

Our weighted study population represented 5.8 million adults with CAD or HF. Among LEP patients with HF, 44% were female and 80% were Hispanic. LEP patients with HF had higher rates of food insecurity (p = 0.01) and poverty (p = 0.002) compared to English speakers. There were no significant differences in symptom burden, medication use, or healthcare utilization patterns among English speakers and LEP patients with HF. Among patients with CAD, there were no significant differences in cardiovascular risk factor control, symptom burden, medication use, or healthcare utilization based on language preference. Approximately, 25% of English-speaking patients with CAD were active smokers compared to 12% of LEP patients (p = 0.034).

Among patients with CAD or HF, language preference did not impact CVD risk factor control, symptom burden, medication use, or healthcare utilization. Future studies exploring other aspects of care, such as access to care and rates of CVD detection in LEP populations, are still warranted.