Locking the Revolving Door: Racial Disparities in Cardiovascular Disease

Velarde, Gladys; Bravo‐Jaimes, Katia; Brandt, Eric; Wang, Daniel; Douglass, Paul; Castellanos, Luis R.; Rodríguez, Fátima; Palaniappan, Latha; Ibebuogu, Uzoma N.; Bond, Rachel M.; Ferdinand, Keith C.; Lundberg, Gina; Thamman, Ritu; Vijayaraghavan, Krishnaswami; Watson, Karol E.

doi:10.1161/jaha.122.025271

Cited by 14 publications

(7 citation statements)

References 94 publications

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“… 34 , 35 , 36 Our results suggest that targeting efforts to identify and address causes in racial differences in SU+CVD mortality may be an important component of addressing known racial disparities in overall CVD outcomes. 37 …”

Section: Discussionmentioning

confidence: 99%

Temporal Trends in Substance Use and Cardiovascular Disease–Related Mortality in the United States

Minhas,

Kewcharoen,

Hall

et al. 2024

JAHA

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Background There are limited data on substance use (SU) and cardiovascular disease (CVD)–related mortality trends in the United States. We aimed to evaluate SU+CVD–related deaths in the United States using the Centers for Disease Control and Prevention Wide‐Ranging, Online Data for Epidemiologic Research database. Methods and Results The Multiple Cause‐of‐Death Public Use record death certificates were used to identify deaths related to both SU and CVD. Crude, age‐adjusted mortality rates, annual percent change, and average annual percent changes with a 95% CI were analyzed. Between 1999 and 2019, there were 636 572 SU+CVD‐related deaths (75.6% men, 70.6% non‐Hispanic White individuals, 65% related to alcohol). Age‐adjusted mortality rates per 100 000 population were pronounced in men (22.5 [95% CI, 22.6–22.6]), American Indian or Alaska Native individuals (37.7 [95% CI, 37.0–38.4]), nonmetropolitan/rural areas (15.2 [95% CI, 15.1–15.3]), and alcohol‐related death (9.09 [95% CI, 9.07 to 9.12]). The overall SU+CVD‐related age‐adjusted mortality rates increased from 9.9 (95% CI, 9.8–10.1) in 1999 to 21.4 (95% CI, 21.2–21.6) in 2019 with an average annual percent change of 4.0 (95% CI, 3.7–4.3). Increases in SU+CVD‐related average annual percent change were noted across all subgroups and were pronounced among women (4.8% [95% CI, 4.5–5.1]), American Indian or Alaska Native individuals, younger individuals, nonmetropolitan areas, and cannabis and psychostimulant users. Conclusions There was a prominent increase in SU+CVD‐related mortality in the United States between 1999 and 2019. Women, non‐Hispanic American Indian or Alaska Native individuals, younger individuals, nonmetropolitan area residents, and users of cannabis and psychostimulants had pronounced increases in SU+CVD mortality.

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Section: Discussionmentioning

confidence: 99%

Temporal Trends in Substance Use and Cardiovascular Disease–Related Mortality in the United States

Minhas,

Kewcharoen,

Hall

et al. 2024

JAHA

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“…Health systems should continue to increase screening for SDOH and create pathways for managing SDOH when they are identified. 2,26,27…”

Section: Discussionmentioning

confidence: 99%

The Impact of Social Determinants of Health and Lifestyle on the Association of Lipoprotein(a) with Myocardial Infarction and Stroke

Brandt,

Kirch,

Patel

et al. 2023

Preprint

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BackgroundIn European cohorts, a higher Mediterranean diet or Life’s Simple 7 (LS7) score abolished or attenuated the risk associated with increasing Lipoprotein(a) [Lp(a)] on cardiovascular outcomes. This is unstudied in US cohorts. The impact of social determinants of health (SDOH) on the association of Lp(a) with cardiovascular outcomes remains unstudied. We sought to test if a SDOH score and LS7 score impacts the association of Lp(a) with myocardial infarction (MI) or stroke.MethodsObservational Cohort of US Adults from the Atherosclerosis Risk in Communities (ARIC) and Multi-Ethnic Study of Atherosclerosis (MESA) cohorts. We performed sequential multivariable Cox proportional hazard analysis, first adjusting for age, gender, non-HDL-C, race and ethnicity, then added SDOH and LS7 scores sequentially. The primary outcomes were time until first fatal or nonfatal MI or stroke.ResultsARIC (n=15,072; median Lp(a)=17.3 mg/dL) had 16.2 years average follow up. MESA (n=6,822; median Lp(a)=18.3 mg/dL had 12.3 years average follow-up. In multivariable analyses adjusted for age, gender, race and ethnicity, and non-HDL-C, Lp(a) was associated (HR, p-value) with MI in ARIC (1.10, <0.001) and MESA (1.09, <0.001), and stroke in ARIC (1.08, <0.001) but not MESA (0.97, 0.50). With SDOH and LS7 added to the model associations remained similar (association of Lp(a) with MI in ARIC 1.09, <0.001 and in MESA 1.10, 0.001, with stroke in ARIC 1.06, <0.003 and in MESA 0.96, 0.39). In models with all covariates, each additional SDOH correlated positively with MI (ARIC 1.13, <0.001; MESA 1.11, <0.001) and stroke (ARIC 1.17, <0.001; HR 1.07, p=0.11) and each additional LS7 score point correlated negatively with MI (ARIC 0.81, <0.001; MESA 0.84, <0.001) and stroke (ARIC 0.82, <0.001; MESA 0.84, <0.001).Conclusions and RelevanceSDOH and lifestyle factors were predictors for MI and stroke that did not impact the association between Lp(a) and cardiovascular events. Our findings support that Lp(a) is an independent risk factor for MI and possibly stroke.

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“…This necessitates the consideration of the variability in factors such as race/ethnicity, sex, and age in brain research, particularly as they pertain to drug development, clinical decision making, and mental health outcomes to ensure adequate representation of different populations and to improve generalizability of research outcomes (Kopal, Uddin, and Bzdok 2023;Li et al 2022). Although incidence rates, prevalence and risks of neurological disorders vary in different racial/ethnic groups, most health research have focused on studying majority white, college-educated populations from North America and European countries (Babulal et al 2019;Haga 2010;Lim et al 2023;Mills and Rahal 2019;Velarde et al 2023). Reporting demographic information is not required by most neuroimaging journals and is poorly documented in most publications (Tzovaras and Tzovara 2019;Li et al 2022;Goldfarb and Brown 2022;Sterling et al 2022).…”

Section: Lack Of Diversity In Publicly Available Datasetsmentioning

confidence: 99%

Creating Diverse and Inclusive Scientific Practices for Research Datasets and Dissemination

Kam,

Badhwar,

Borghesani

et al. 2024

Preprint

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Diversity, equity, and inclusivity (DEI) are important for scientific innovation and progress. This widespread recognition has resulted in numerous initiatives for enhancing DEI in recent years. Although progress has been made to address gender and racial disparities, there remains to be biases that limit the opportunities for historically underrepresented individuals to succeed in academia. As members of the Organization for Human Brain Mapping (OHBM) Diversity and Inclusivity committee (DIC), we identified the most challenging and imminent obstacles towards improving DEI practices in the broader neuroimaging field. These obstacles include the lack of diversity in and accessibility to publicly available datasets, barriers in research dissemination, and/or barriers related to publishing. In order to increase diversity and promote equity and inclusivity in our scientific endeavors, we suggest potential solutions that are practical and actionable to overcome these barriers. We emphasize the importance of the enduring and unwavering commitment required to advance DEI initiatives consistently. By doing so, the OHBM and perhaps other neuroscience communities will strive towards a future that is not only marked by scientific excellence but also characterized by diversity, inclusivity and equitable opportunities for all including historically underrepresented individuals internationally.

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Locking the Revolving Door: Racial Disparities in Cardiovascular Disease

Cited by 14 publications

References 94 publications

Temporal Trends in Substance Use and Cardiovascular Disease–Related Mortality in the United States

Temporal Trends in Substance Use and Cardiovascular Disease–Related Mortality in the United States

The Impact of Social Determinants of Health and Lifestyle on the Association of Lipoprotein(a) with Myocardial Infarction and Stroke

Creating Diverse and Inclusive Scientific Practices for Research Datasets and Dissemination

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