Disparities in Cardiovascular Care and Outcomes for Women From Racial/Ethnic Minority Backgrounds

Abstract

Purpose of review Racial, ethnic, and gender disparities in cardiovascular care are well-documented. This review aims to highlight the disparities and impact on a group particularly vulnerable to disparities, women from racial/ethnic minority backgrounds. Recent findings Women from racial/ethnic minority backgrounds remain underrepresented in major cardiovascular trials, limiting the generalizability of cardiovascular research to this population. Certain cardiovascular risk factors are more prevalent in women from racial/ethnic minority backgrounds, including traditional risk factors such as hypertension, obesity, and diabetes. Female-specific risk factors including gestational diabetes and preeclampsia as well as non-traditional psychosocial risk factors like depressive and anxiety disorders, increased child care, and familial and home care responsibility have been shown to increase risk for cardiovascular disease events in women more so than in men, and disproportionately affect women from racial/ethnic minority backgrounds. Despite this, minimal interventions to address differential risk have been proposed. Furthermore, disparities in treatment and outcomes that disadvantage minority women persist. The limited improvement in outcomes over time, especially among non-Hispanic Black women, is an area that requires further research and active interventions. Summary Understanding the lack of representation in cardiovascular trials, differential cardiovascular risk, and disparities in treatment and outcomes among women from racial/ethnic minority backgrounds highlights opportunities for improving cardiovascular care among this particularly vulnerable population.

Nativity-Related Disparities in Preeclampsia and Cardiovascular Disease Risk Among a Racially Diverse Cohort of US Women

“…Compared with women of other racial and ethnic groups, non-Hispanic Black women have the highest prevalence of cardiovascular risk factors, including chronic hypertension and obesity, as seen in this present study. 34 , 35 , 36 Chronic hypertension and prepregnancy obesity are important modifiable risk factors for preeclampsia. 37 Effective management of chronic hypertension, use of aspirin as a preventive strategy in high-risk women, and reduction in prepregnancy obesity can reduce the risk of preeclampsia among non-Hispanic Black women and potentially narrow the racial and ethnic disparity gap.…”

Cardiovascular Disease Prevention and Therapy in Women With Type 2 Diabetes

“…Women with T2DM are less likely to achieve target values for systolic blood pressure, low-density lipoprotein and high-density lipoprotein cholesterol, fasting plasma glucose and hemoglobin A1c. Regarding treatment, women are more likely than men to take insulin, either alone or in combination with oral hypoglycemic drugs [12]. Although aging induces body composition changes in both sexes, menopause predisposes women to the accumulation of visceral fat.…”

“…In addition, adequate physical activity and a healthy diet improve the immune response [12,58]. After the pandemic, global action in support of a healthy diet and physical activity will be mandatory to encourage people to return to a good lifestyle.…”

Low-Density Lipoprotein Cholesterol Treatment Rates in High Risk Patients: More Disappointment Despite Ever More Refined Evidence-Based Guidelines.

“…Female sex, identifying as belonging to a non-white ethnic group, older and younger age, and low socioeconomic position are among the most important predictors for low statin adherence [12] . This may explain at least partly why there continues to be disparities in cardiovascular care for women and those identifying as belong to a non-white ethnic group [ 13 , 14 ]. Not surprisingly, reduced adherence to statin therapy correlates with increased risk for ASCVD events and higher healthcare costs in proportion to the lack of adherence [15] .…”