Disparities in Cardiovascular Disease Risk in the United States

被引:309
作者
Graham, Garth [1 ]
机构
[1] Univ Florida, Dept Med, POB 100227, Gainesville, FL 32610 USA
关键词
Acute coronary; syndrome heart disease; health disparities; hypertension;
D O I
10.2174/1573403X11666141122220003
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
This is a comprehensive narrative review of the literature on the current science and evidence of population-level differences in risk factors for heart disease among different racial and ethnic population in the United States (U. S.). It begins by discussing the importance of population-level risk assessment of heart disease in light of the growth rate of specific minority populations in the U. S. It describes the population-level dynamics for racial and ethnic minorities: a higher overall prevalence of risk factors for coronary artery disease that are unrecognized and therefore not treated, which increases their likelihood of experiencing adverse outcome and, therefore, potentially higher morbidity and mortality. It discusses the rate of Acute Coronary Syndrome (ACS) in minority communities. Minority patients with ACS are at greater risk of myocardial infarction (MI), rehospitalization, and death from ACS. They also are less likely than non-minority patients to receive potentially beneficial treatments such as angiography or percutaneous coronary intervention. This paper looks at the data surrounding the increased rate of heart disease in racial and ethnic minorities, where the risk is related to the prevalence of comorbidities with hypertension or diabetes mellitus, which, in combination with environmental factors, may largely explain CHF disparity. The conclusion is that it is essential that healthcare providers understand these various communities, including nuances in disease presentation, risk factors, and treatment among different racial and ethnic groups. Awareness of these communities' attributes, as well as differences in incidence, risk factor burdens, prognosis and treatment are necessary to mitigate racial and ethnic disparities in heart disease.
引用
收藏
页码:238 / 245
页数:8
相关论文
共 66 条
[1]   Predicting coronary risk in UK South Asians: an adjustment method for Framingham-based tools [J].
Aarabi, M ;
Jackson, PR .
EUROPEAN JOURNAL OF CARDIOVASCULAR PREVENTION & REHABILITATION, 2005, 12 (01) :46-51
[2]   Ethnic differences in cardiovascular risk factors in healthy Caucasian and South Asian individuals with the metabolic syndrome [J].
Ajjan, R. ;
Carter, A. M. ;
Somani, R. ;
Kain, K. ;
Grant, P. J. .
JOURNAL OF THROMBOSIS AND HAEMOSTASIS, 2007, 5 (04) :754-760
[3]   Prevalence of and risk factors for subclinical cardiovascular disease in selected US hispanic ethnic groups [J].
Allison, Matthew A. ;
Budoff, Matthew J. ;
Wong, Nathan D. ;
Blumenthal, Roger S. ;
Schreiner, Pamela J. ;
Criqui, Michael H. .
AMERICAN JOURNAL OF EPIDEMIOLOGY, 2008, 167 (08) :962-969
[4]   N-terminal prohormone brain natriuretic peptide as a predictor of cardiovascular disease and mortality in blacks with hypertensive kidney disease - The African American Study of Kidney Disease and Hypertension (AASK) [J].
Astor, B. C. ;
Yi, S. ;
Hiremath, L. ;
Corbin, T. ;
Pogue, V. ;
Wilkening, B. ;
Peterson, G. ;
Lewis, J. ;
Lash, J. P. ;
Van Lente, F. ;
Gassman, J. ;
Wang, X. ;
Bakris, G. ;
Appel, L. J. ;
Contreras, G. .
CIRCULATION, 2008, 117 (13) :1685-1692
[5]   Differences in the Incidence of Congestive Heart Failure by Ethnicity - The Multi-Ethnic Study of Atherosclerosis [J].
Bahrarni, Hossein ;
Kronmal, Richard ;
Bluemke, David A. ;
Olson, Jean ;
Shea, Steven ;
Liu, Kiang ;
Burke, Gregory L. ;
Lima, Joao A. C. .
ARCHIVES OF INTERNAL MEDICINE, 2008, 168 (19) :2138-2145
[6]   Inequity in recording of risk in a local population-based screening programme for cardiovascular disease [J].
Bartys, S ;
Baker, D ;
Lewis, P ;
Middleton, E .
EUROPEAN JOURNAL OF CARDIOVASCULAR PREVENTION & REHABILITATION, 2005, 12 (01) :63-67
[7]   N-terminal fragment of the prohormone brain-type natriuretic peptide (NT-proBNP), cardiovascular events, and mortality in patients with stable coronary heart disease [J].
Bibbins-Domingo, Kirsten ;
Gupta, Reena ;
Na, Beeya ;
Wu, Alan H. B. ;
Schiller, Nelson B. ;
Whooley, Mary A. .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2007, 297 (02) :169-176
[8]   Ethnic differences in coronary calcification - The multi-ethnic study of atherosclerosis (MESA) [J].
Bild, DE ;
Detrano, R ;
Peterson, D ;
Guerci, A ;
Liu, K ;
Shahar, E ;
Ouyang, P ;
Jackson, S ;
Saad, MF .
CIRCULATION, 2005, 111 (10) :1313-1320
[9]   The cardiovascular state of the union - Confronting healthcare disparities [J].
Bonow, RO ;
Grant, AO ;
Jacobs, AK .
CIRCULATION, 2005, 111 (10) :1205-1207
[10]   Racial disparities in stroke risk factors - The impact of socioeconomic status [J].
Bravata, DM ;
Wells, CK ;
Gulanski, B ;
Kernan, WN ;
Brass, LM ;
Long, J ;
Concato, J .
STROKE, 2005, 36 (07) :1507-1511