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Historically Marginalized And Minoritized Populations With PAH: A Deeper Dive Into a Complex Question.

Roberto J Bernardo¹, Victor E Ortega², Jason Glenn³

¹Division of Pulmonary, Allergy and Critical Care Medicine, Stanford University, Stanford, CA; Vera Moulton Wall Center for Pulmonary Vascular Disease, Stanford University, Stanford, CA.

|July 14, 2026

Summary

Pulmonary arterial hypertension (PAH) disparities disproportionately impact minority groups. Addressing social determinants and medical mistrust is crucial for achieving health equity in PAH care.

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Area of Science:

Cardiology
Public Health
Health Equity

Background:

Pulmonary arterial hypertension (PAH) disproportionately affects minority populations, including Black, Hispanic, and American Indian individuals.
Existing disparities in epidemiology, clinical outcomes, and healthcare access require urgent attention.
Historical exploitation has led to medical mistrust within these communities, impacting care.
Race and ethnicity are social constructs with implications for understanding health disparities.

Purpose of the Study:

To examine disparities in pulmonary arterial hypertension (PAH) through cross-cutting themes and population-specific evidence.
To analyze the role of race and ethnicity as social constructs in PAH.
To review the significance of socioeconomic factors in clinical outcomes across diverse populations.

Main Methods:

State-of-the-art review of existing literature on PAH disparities.
Examination of genetic ancestry research within the framework of race as a social variable.
Analysis of population-specific data on clinical phenotypes, survival, and healthcare access.

Main Results:

Disparities in PAH epidemiology, clinical outcomes, and access to care are evident across racial and ethnic lines.
Socioeconomic deprivation significantly impacts clinical outcomes in PAH patients.
Genetic ancestry research must be framed within social, not biological, definitions of race.

Conclusions:

Achieving health equity in pulmonary hypertension care requires addressing social determinants, medical mistrust, and systemic biases.
A framework for shared efforts is proposed to reduce disparities in PAH.
Further research is needed to fill knowledge gaps and promote equitable care for all populations affected by PAH.