Heart Matters: Gender and Racial Differences Cardiovascular Disease Risk Factor Control Among Veterans

Goldstein, Kenneth M.; Melnyk, S. Dee; Zullig, Leah L.; Stechuchak, Karen M.; Oddone, Eugene Z.; Bastian, Lori A.; Rakley, Susan; Olsen, Maren K.; Bosworth, Hayden B.

doi:10.1016/j.whi.2014.05.005

Cited by 34 publications

(35 citation statements)

References 41 publications

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“…In the past decade, researchers have reported poorer glycemic control among minority veterans compared to non-Hispanic whites, [25][26][27] as well as gender disparities in diabetes outcomes among veterans. [28][29][30][31] In our sample, females and non-Hispanic blacks were less likely to have lipid control (relative to males and non-Hispanic whites) and non-Hispanic blacks were less likely to have glycemic control (relative to non-Hispanic whites). However, when we examined gender and race as moderators of the relationship between time and each outcome, we found that racial disparities in glycemic control were reduced in 2012, relative to 2009.…”

Section: Discussionmentioning

confidence: 63%

Impact of Patient-Centered Medical Home Implementation on Diabetes Control in the Veterans Health Administration

et al. 2018

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Section: Discussionmentioning

confidence: 63%

Impact of Patient-Centered Medical Home Implementation on Diabetes Control in the Veterans Health Administration

et al. 2018

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“…Nonquantifiable risk factors are much broader and include language barriers and lack of healthcare access [4], low and medium educational levels [17], having a negative affect in familial interactions [25], and poor health promotion behaviors including low knowledge of personal risk indicators for CVD [26,27]. Minority status also is recognized as an independent risk factor for high blood pressure, heart attack and stroke [28], lower rates of moderate exercise [29], decreased cholesterol medication adherence [30], lower likelihood of prior lipid screening among children with stroke[s] [31], increased LDL-C, BP, and A1c among veterans [32], and even increased all-cause mortality [33].…”

Section: Discussionmentioning

confidence: 99%

Screening and socioeconomic associations of dyslipidemia in young adults

et al. 2020

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Background: The Southern region of the United States is home to substantial populations with obesity, dyslipidemia, and hypertriglyceridemia, while also housing a large percentage of America's minority, rural, and low socioeconomic status (SES) peoples. Adult-onset cardiovascular disease (CVD) research may be informed by investigating associations(s) between late adolescent demographic variables and lipid values. Our objective was to investigate lipid parameter associations with college-age socioeconomic status, which may improve age-specific screening algorithms for management or prevention of adult-onset CVD. Methods: Using an Analysis of Variance test and a general linear model, associations between gender, race/ethnicity, SES, and athletic participation on lipid parameters (VLDL-C, LDL-C, TG, TC, and HDL-C) were analyzed in 4423 private liberal arts college students enrolled in freshman-level wellness courses at Furman University in Greenville, SC. Comparative data were collected from an age-matched sample (National Health and Nutrition Examination Survey: NHANES 2003-2016). Our main outcomes were statistically significant relationships between any lipid values (TC, HDL-C, LDL-C, TG) and any demographic variables (gender, SES, ethnicity, athlete status). Results: Males demonstrated lower TC and LDL-C, and higher HDL-C values. HDL-C was highest in athletes. African-American students demonstrated healthier VLDL-C, TG, and HDL-C values. With similar distributions, the age-matched NHANES comparison group showed unhealthier values in nearly all categories. Conclusions: College students may have better lipid health than the general population. African-Americans may have seemingly healthier lipid values than age-matched individuals independent of athletic or college enrollment which has already been demonstrated in other studies. Future research should include SES relationships in lipid screening paradigms along with other appropriate risk factors for cardiovascular disease. Based on our comparative data, pediatric health providers and researchers may consider education as a potential protective factor against poor lipid health when considering lipid screening protocols for students.

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“…Female veterans are also less likely to have someone accompany them to a doctor’s visit (65) , more likely to live alone (65) , and more likely to be homeless (66) . Among veterans, disparities in LDL goal achievement persist (67) despite overall improvements in gender inequities within the VA (48) ; these disparities are most notable among older women veterans and those women with known ischemic heart disease (11) . Understanding the impact of poor social support in the veteran population can help provide insights for other high risk groups and possible underlying causes of disparities in their hyperlipidemia control.…”

Section: Discussionmentioning

confidence: 99%

Impact of Gender on Satisfaction and Confidence in Cholesterol Control Among Veterans at Risk for Cardiovascular Disease

Goldstein¹,

Stechuchak²,

Zullig

et al. 2017

Journal of Women's Health

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Background Compared to men, women have poorer lipid control. While potential causes of this disparity have been explored, it is unknown whether patient-centered factors such as satisfaction and confidence contribute. We evaluated: 1) if satisfaction with lipid control and confidence in ability to improve it vary by gender; and 2) whether socio-demographic characteristics modify the association. Methods We evaluated baseline survey responses from the Cardiovascular Intervention Improvement Telemedicine Study, including self-rated satisfaction with cholesterol levels and confidence in controlling cholesterol. Participants had poorly controlled hypertension and/or hypercholesterolemia. Results 428 Veterans (15% women) participated. Compared with men, women had higher LDL values at 141.2 mg/dL vs. 121.7 mg/dL respectively (p<0.05), higher health literacy, and were less likely to have someone to help track their medications (all p<0.05). In an adjusted model, women were less satisfied with their cholesterol levels than men with estimated mean scores of 4.3 versus 5.6 on a 1–10 Likert scale (p<0.05). There was no significant difference in confidence by gender. Participants with support for tracking medications reported higher confidence levels than those without, estimated mean 7.8 vs. 7.2 (p<0.05). Conclusions Women veterans at high risk for cardiovascular disease were less satisfied with their lipid control than men; however, confidence in ability to improve lipid levels was similar. Veterans without someone to help to track medications were less confident, and women were less likely to have this type of social support. Lack of social support for medication tracking may be a factor in lingering gender-based disparities in hyperlipidemia.

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Heart Matters: Gender and Racial Differences Cardiovascular Disease Risk Factor Control Among Veterans

Cited by 34 publications

References 41 publications

Impact of Patient-Centered Medical Home Implementation on Diabetes Control in the Veterans Health Administration

Impact of Patient-Centered Medical Home Implementation on Diabetes Control in the Veterans Health Administration

Screening and socioeconomic associations of dyslipidemia in young adults

Impact of Gender on Satisfaction and Confidence in Cholesterol Control Among Veterans at Risk for Cardiovascular Disease

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