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Efforts to improve CHD risk-factor control may reduce racial, ethnic disparities
In a study of more than 1.3 million patients in the Kaiser Permanente Health System in Northern California, Asian, black and Hispanic adults had lower risk for CHD compared with white adults.
“Racial and ethnic differences in diabetes, [CVD] risk factors and their outcomes, especially in blacks, are well documented, but population health estimates are often confounded by differences in access to high-quality health care,” Jamal S. Rana, MD, PhD, from the division of cardiology and clinical adjunct with division of research at Kaiser Permanente Northern California, said in a press release. “We were able to evaluate ethnic differences in risk of future [CHD] within a diverse population, which included not only black, but also large Asian and Latino populations, with uniform access to care in an integrated health care delivery system.”
Of the 1,344,899 patients in the study cohort, 64% were white, 14% Asian, 13% Hispanic and 9% black. More than 10% of the Hispanic patients and nearly 20% of the black patients lived in economically disadvantaged neighborhoods.
Patients were aged 30 to 90 years and were categorized into four clinical risk categories:
- no diabetes with no prior CHD;
- no diabetes with prior CHD;
- diabetes with no prior CHD; and
- diabetes with prior CHD.
According to the findings, black, Hispanic and Asian adults without any prior history of CHD had lower risk for CHD compared with white adults, regardless of the presence of diabetes. Among the group with prior CHD and no diabetes, black adults had slightly increased risk for future CHD compared with white adults. Increased risk, however, was not observed in the group with both prior history of CHD and diabetes. The risk ratio for Hispanic adults was similar to that for white adults in both these groups, whereas Asian adults had a decreased risk compared with white adults.
“The results in our report may reflect, not only access to high-quality heart disease care, but also systematic efforts by the health plan to improve risk factors such as high [BP] and promote smoking cessation across its member population,” Rana said. “Our findings are very encouraging. It is a complex issue, and further research is needed to address the differences in health status and outcomes related to race and ethnicity across the country.” – by Tracey Romero
Disclosure: The study was funded by the Kaiser Permanente Northern California Community Benefit Program. The researchers report no relevant financial disclosures.