Racial disparities and cardiovascular disease: One size fits all approach?

Karnati, Santoshi A; Wee, Alexandra; Shirke, Manasi Mahesh; Harky, Amer

doi:10.1111/jocs.15047

Cited by 11 publications

(9 citation statements)

References 78 publications

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“…Compared to non-Hispanic white women, non-Hispanic Black women had a higher CVD event risk, but Chinese and Japanese women had lower risk. These trends are broadly consistent with prior literature (Holland et al, 2011; Karnati et al, 2020; Winkleby et al, 1998). In addition to higher CVD risk, non-Hispanic Black midlife and older women generally have worse PF compared to non-Hispanic white women (Sowers et al, 2006).…”

Section: Discussionsupporting

confidence: 92%

Pre- and Early Peri-menopausal Physical Function and Risk of Cardiovascular Events: The Study of Women’s Health Across the Nation

et al. 2022

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Objectives To determine whether physical function (PF) before menopause is related to cardiovascular disease (CVD) risk. Methods Participants were N = 2950 pre-/early peri-menopausal women (median age 46, (25th–75th percentile: 43–48 years). Physical function was assessed at baseline using the Physical Function subscale of the SF-36 and scores were trichotomized (no, some, or substantial limitations). Clinical CVD events were ascertained at annual/biennial clinical assessments through the 15th follow-up visit. Risk of CVD was determined with Cox proportional hazards models. Results: Women were followed for a median of 19.1 years, during which 220 women had a CVD event. In fully adjusted models, women with substantial limitations at baseline had higher CVD risk compared to women with no limitations (hazards ratio [HR] = 1.55, 95% confidence interval [CI]: 1.12–2.33). Discussion: Substantial PF limitations in pre- and early peri-menopausal women are associated with higher risk of clinical CVD events, consistent with literature in older adults.

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Section: Discussionsupporting

confidence: 92%

Pre- and Early Peri-menopausal Physical Function and Risk of Cardiovascular Events: The Study of Women’s Health Across the Nation

et al. 2022

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“…Racial disparities in patient care have been shown to significantly impede equitable healthcare delivery. Racial minorities reportedly receive lower quality of care and face greater morbidity for different chronic diseases compared to nonminorities [69][70][71][72][73][74]. In fact, the infant mortality rate per 1000 livebirths for Black, non-Hispanic children (10.8) is more than double the rate for White, non-Hispanic children (4.9) [75].…”

Section: Racementioning

confidence: 99%

Impact of Social Determinants of Health in Spine Surgery

Reyes

Bajaj

Alvandi

et al. 2022

Curr Rev Musculoskelet Med

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Purpose of Review Social determinants of health (SDH) are factors that affect patient health outcomes outside the hospital. SDH are “conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.” Current literature has shown SDH affecting patient reported outcomes in various specialties; however, there is a dearth in research relating spine surgery with SDH. The aim of this review article is to identify connections between SDH and post-operative outcomes in spine surgery. These are important, yet understudied predictors that can impact health outcomes and affect health equity. Recent Findings Few studies have shown associations between SDH pillars (environment, race, healthcare, economic, and education) and spine surgery outcomes. The most notable relationships demonstrate increased disability, return to work time, and pain with lower income, education, environmental locations, healthcare status and/or provider. Despite these findings, there remains a significant lack of understanding between SDH and spine surgery. Summary Our manuscript reviews the available literature comparing SDH with various spine conditions and surgeries. We organized our findings into the following narrative themes: 1) education, 2) geography, 3) race, 4) healthcare access, and 5) economics.

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“…It is well recognized that racial and socioeconomic factors contribute to inequality in health care, particularly in privatized healthcare systems in which financial cost may be a significant barrier to accessing healthcare. 11 This is relevant in the context of novel therapies for ATTR amyloidosis for which the annual cost per patient ranges from $225 000 to $450 000. 4 It is thus difficult to exclude a contribution to poor outcomes in p.(V142I)-ATTRv-CM from inequitable access to health care.…”

Section: Introductionmentioning

confidence: 99%

Deep phenotyping of p.(V142I)‐associated variant transthyretin amyloid cardiomyopathy: Distinct from wild‐type transthyretin amyloidosis?

Razvi,

Ioannou,

Patel

et al. 2024

European J of Heart Fail

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AimsTransthyretin amyloid cardiomyopathy (ATTR‐CM) is an increasingly recognised cause of heart failure. 3‐4% of individuals of African descent carry a TTR gene mutation encoding the p.(V142I) variant, a powerful risk factor for development of variant ATTR‐CM; this equates to 1.6 million carriers in the USA. We undertook deep phenotyping of p.(V142I)‐ATTRv‐CM and comparison with wild‐type ATTR‐CM (ATTRwt‐CM).Methods & ResultsA retrospective study of 413 patients with p.(V142I)‐associated ATTR‐CM (ATTRv‐CM) who attended the UK National Amyloidosis Centre was conducted. Patients underwent evaluation at time of diagnosis, including clinical, echocardiography, and biomarker analysis; a subgroup had cardiac magnetic resonance imaging (CMR). Four hundred and thirteen patients with wild‐type ATTR‐CM (ATTRwt‐CM), matched for independent predictors of prognosis (age, NAC Stage, decade of first presentation), were used as a comparator group.At time of diagnosis, patients with ATTRv‐CM had significant functional impairment by NYHA classification (NHYA ≥ III; 38%) and 6‐minute walk test distance (median 276 metres). Median 5‐year survival in ATTRv‐CM patients was 31 months vs 59 months in matched patients with ATTRwt‐CM (p<0.001). Patients with ATTRv‐CM had significant impairment of functional parameters by echocardiography including biventricular impairment, high burden of regurgitant valvular disease and low cardiac output. Multivariable analysis revealed the prognostic importance of RV dysfunction. CMR and histological analysis revealed myocyte atrophy and widespread myocardial infiltration in ATTRv‐CM.Conclusionp.(V142I)‐ATTRv‐CM has an aggressive phenotype characterised by myocyte loss and widespread myocardial infiltration which may account for frequent biventricular failure and poor prognosis in this ATTR‐CM genotypic subgroup.This article is protected by copyright. All rights reserved.

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Racial disparities and cardiovascular disease: One size fits all approach?

Cited by 11 publications

References 78 publications

Pre- and Early Peri-menopausal Physical Function and Risk of Cardiovascular Events: The Study of Women’s Health Across the Nation

Pre- and Early Peri-menopausal Physical Function and Risk of Cardiovascular Events: The Study of Women’s Health Across the Nation

Impact of Social Determinants of Health in Spine Surgery

Deep phenotyping of p.(V142I)‐associated variant transthyretin amyloid cardiomyopathy: Distinct from wild‐type transthyretin amyloidosis?

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