Cardiovascular multimorbidity: the effect of ethnicity on prevalence and risk factor management

Abstract

BackgroundMultimorbidity is common in primary care populations. Within cardiovascular disease, important differences in disease prevalence and risk factor management by ethnicity are recognised.

Geographic and Racial/Ethnic Variations in Patterns of Multimorbidity Burden in Patients with Type 2 Diabetes

“…Similar to other studies, older age (77-78% of this cohort 65+ years old) showed the highest odds of medical comorbidity. 8,14,27 However, among those with at least 50% service-connected disability, the highest odds of comorbidity type were driven by mental health.…”

“…The significantly lower multimorbidity among married veterans resonates with other studies showing this finding as an important support mechanism for male versus female veterans. 31 Prior studies of racial/ethnic, regional, and rural/urban differences in diabetes outcomes [14][15][16][17][18] demonstrated a twofold higher potential for physical multimorbidity in non-Hispanic black patients due to poorer control of CVD risk factors and a lower rate of medication adherence. This study found that non-Hispanic black patients had 25-67% greater risk of medical, mental health, and combined comorbidities.…”

“…The synergistic effect of the greater number of medical and mental health comorbidities present in more disadvantaged populations is a contributing factor to the gap in health equity evidenced in the literature. [7][8][9][13][14][15][16][17][18] The prevalence of coexisting medical and mental health conditions is clear among disadvantaged populations, with a convincing base of evidence. One study in a Scottish population (1.75 million) found that individuals in the most socioeconomically deprived areas had 10-15 years' earlier onset of multimorbidity and 11-fold higher odds of both physical and mental health disorders than their wealthier counterparts.…”

“…Moreover, multimorbidity has been shown to vary widely in different settings based on socioeconomic status and race/ethnicity. 13,14 Racial/ethnic, regional, and rural/urban differences in diabetes control, medication adherence, and mortality are welldocumented among individuals with diabetes. [15][16][17][18] Given the prevalence of comorbid mental health disorders, it is also of particular interest to examine variations in psychiatric versus somatic disorders in patients with diabetes.…”

2016 European Guidelines on cardiovascular disease prevention in clinical practice

“…Management of DM is also significantly worse, while management of high BP and hypercholesterolaemia is better among South Asians than host country natives. 220 The higher CVD risk among South…”