Historically Marginalized and Minority Populations With Pulmonary Arterial Hypertension: A Deeper Dive Into a Complex...

Pulmonary arterial hypertension (PAH) is a progressive cardiopulmonary disorder with disparities in epidemiologic features, clinical outcomes, and health care access that disproportionately affect historically neglected populations, including Black Americans, Hispanic Americans, and American Indians.

This state-of-the-art review examined PAH disparities through cross-cutting themes and population-specific evidence. First, we examined the role of race and ethnicity as social constructs; the historical roots of medical mistrust arising from documented exploitation of Black, Hispanic, and American Indian communities; and the implications of genetic ancestry research within the framework of race as a social, rather than biological, variable. We then reviewed population-specific evidence on clinical phenotypes, survival, and access to care and reviewed the significance of socioeconomic deprivation in clinical outcomes across populations.

This review highlights existing gaps in knowledge and proposes a framework for shared efforts toward the common goal of achieving health equity in pulmonary hypertension care.