Increased awareness of racial, ethnic disparities may improve CV risk factor modification

CHICAGO — Results of a study presented at the National Lipid Association Scientific Sessions highlight disparities among racial and ethnic groups in various CV risk factors consistent with prior research.

The observational study included 769 patients undergoing elective coronary or peripheral intervention at New York University Langone Medical Center. Researchers obtained information on demographics, medical history, medication use and lifestyle factors through patient interview and questionnaire responses. Within 2 weeks of the intervention, researchers also performed a lipid profile and measured HbA1c levels. Patients were stratified by four racial/ethnic groups — non-Hispanic white, Hispanic white, black and Asian — and researchers identified the proportion of patients in each group who were “at goal” for each of the evaluated risk factors for CVD as indicated by guidelines from the American Heart Association.

CV risk factors

Black and Hispanic patients were less likely to achieve a BP goal of less than 140 mm Hg/90 mm Hg and LDL goal of less than 70 mg/dL (P = .0086). Black patients had the highest LDL levels and the lowest triglyceride levels, but the difference between the four groups in the proportion of patients at the goal value of less than 150 mg/dL for triglycerides was not significant.

Asian patients with diabetes were more likely than patients with diabetes in the other three groups to achieve an HbA1c level of less than 7%, but this difference also was nonsignificant.

Lifestyle

At enrollment, black and Asian patients were more likely to report smoking (P = .023). Although all four groups had a low proportion of patients who met the goal of more than 120 minutes per week of physical activity, this proportion was highest among Asian patients (26.98% vs. 10.64%-14.38% in the other groups; P = .045). High vegetable intake was low in all four groups (< 6%) and was not significantly different between the groups.

Hispanic patients were more likely to consume one or more cups of sugared drinks per day compared with the other groups (P < .0001). The researchers also observed a numerically lower number of Hispanic patients who reported daily sodium consumption of less than 0.5 teaspoons per day, but this difference was not significant.

Medication use

Overall, antiplatelet therapy use was reported in 93.29% of non-Hispanic whites, 86.27% of white Hispanics, 85.42% of blacks and 87.63% of Asians in this study. Antiplatelet therapies included aspirin, clopidogrel, prasugrel (Effient, Daiichi Sankyo/Eli Lilly) or ticagrelor (Brilinta, AstraZeneca).

Statin use also was less common among white Hispanics (68.63%) and blacks (69.31%) compared with non-Hispanic whites (80.43%) and Asians (76%; P = .031).

Increased awareness

“Differences in the use of preventive medication may reflect prescriber or patient preference and could potentially also be targeted. ... Being informed about specific disparities may influence and focus the way physicians interact with patients of different communities, which will then inform treatment options,” Hayeem Rudy, of NYU Langone Medical Center, said during a presentation. – by Adam Taliercio

Reference:

Rudy H, et al. Abstract #181. Presented at: National Lipid Association Scientific Sessions; June 11-14, 2015; Chicago.

Disclosure: Rudy reports no relevant financial disclosures.