ミシガン州における心血管疾患スクリーニングの系統的レビュー：十分に行われているか？

Cardiovascular disease (CVD) remains the leading cause of death in the United States, with persistent disparities in access to preventive screening. This systematic review investigates how racial, geographic, and socioeconomic factors influence cardiovascular screening rates across Michigan, focusing on blood pressure and cholesterol screening across various groups. A systematic search of PubMed, Embase, Scopus, Web of Science, and Google Scholar was conducted for studies published through October 2025. Eligible studies reported Michigan-specific data on preventive cardiovascular screening, operationally defined as blood pressure measurement, and/or lipid testing in adults. Twelve studies met the inclusion criteria, and methodological quality was assessed using study-design-appropriate appraisal tools, including the NIH quality assessment instrument. Across studies, Black, rural, uninsured, and low-income populations consistently demonstrated lower screening rates compared with White, urban, and insured groups. Reported disparities in screening ranged from approximately 5%-15% points across racial and socioeconomic strata, depending on population and data source. Policy and community-based interventions, including Medicaid expansion and mobile screening initiatives, were associated with modest increases in screening, although effects were variable and not uniformly sustained. Overall, preventive cardiovascular screening in Michigan remains unevenly distributed, highlighting persistent equity gaps and the need for more consistent, statewide screening strategies.