Trends in Racial/Ethnic Disparities in Cardiovascular Health Among US Adults From 1999–2012

Abstract

BackgroundIn the United States, there are persistent racial and ethnic disparities in cardiovascular disease morbidity and mortality. National efforts have focused on reducing these disparities; however, little is known about the long‐term trends in racial/ethnic disparities in cardiovascular health (CVH).Methods and ResultsWe included 11 285 adults aged ≥20 years from the National Health and Nutrition Examination Surveys survey cycles 1999/2000 through 2011/2012. CVH includes 7 health factors and behaviors—diet, physical activity, smoking status, body mass index, blood pressure, blood glucose, and total cholesterol—each scored as ideal (2 points), intermediate (1 point), or poor (0 points). Overall CVH is a summation of these scores (range, 0–14) points. Age‐adjusted mean CVH scores were calculated by race/ethnicity (non‐Hispanic black, non‐Hispanic white, or Mexican American) and sex for each survey cycle. Non‐Hispanic black women had significantly lower mean CVH scores as compared with non‐Hispanic white women at each survey cycle (difference=0.93; P=0.001 in 2011/2012) and Mexican‐American women had significantly lower mean score as compared with non‐Hispanic white women at almost all survey cycles (difference=0.71; P=0.02 in 2011/2012). Differences between racial/ethnic groups were smaller for men and were mostly nonsignificant.ConclusionsFrom 1999/2000 to 2011/2012, there were enduring disparities in CVH for non‐Hispanic black and Mexican‐American women as compared with non‐Hispanic white women. Disparities that were present in 1999/2000 were present in 2011/2012, though no racial/ethnic differences became more pronounced over time. These findings provide US nationally representative data to evaluate health factors and behaviors of particular concern regarding racial/ethnic disparities in cardiovascular health.

Statin Use in the U.S. for Secondary Prevention of Cardiovascular Disease Remains Suboptimal

“…Then, we conducted a multivariable logistic regression analysis of whether sociodemographic characteristics were associated with statin use among those with a history of ASCVD using pooled data from 2014 through 2016, the 3 years that follow the publication of the 2013 ACC/AHA guidelines. [15][16][17][18] Statin use for secondary prevention was defined as 1 or more prescriptions filled within the calendar year among our population of interest, those aged 40 and older with a history of diagnosed ASCVD. 20 We identified generic and brand-name statin fills from all prescription drug fills reported using Cerner Multum drug codes and/or medication names.…”

“…We also assessed whether individual sociodemographic characteristics are associated with statin use for individuals with a history of ASCVD. Given known disparities in ASCVD treatment among women and racial/ethnic minorities, [15][16][17][18] we wanted to understand whether these disparities persisted using the most current data available. We also capture those who are on Medicaid (only or dually eligible for Medicare) or uninsured, populations that are often missed in claims-based analyses that typically include only those with Medicare and/or private coverage.…”

Machine Learning-Augmented Propensity Score-Adjusted Multilevel Mixed Effects Panel Analysis of Hands-On Cooking and Nutrition Education versus Traditional Curriculum for Medical Students as Preventive Cardiology: Multisite Cohort Study of 3,248 Trainees over 5 Years

“…Yet nearly 40% of CVD is attributed to modifiable social determinants of health including poor diet, exercise, and smoking which worsen endothelial function and arterial compliance [ 5 ]. These trends are further complicated by health disparities including racial and sexual [ 6 ]. Aside from the ethical toll, health disparities every year account for over 1 in 10 health expenditure dollars or $1.24 trillion every three years [ 7 , 8 ].…”

Race/Ethnic and Sex Differences in the Association of Atherosclerotic Cardiovascular Disease Risk and Healthy Lifestyle Behaviors

“…Moreover, racial/ethnic differences in overall cardiovascular health may be more prominent for women than for men. 3 Estimates suggest that %44% of the decline in ASCVD death rates is attributable to improvements in CVD-related lifestyle and behavior factors, including improvements in rates of smoking, physical inactivity, and control of systolic blood pressure and total cholesterol. 4 However, declines in the prevalence of these risk factors are being offset by the increasing prevalence of obesity and diabetes mellitus.…”