Black, Hispanic, Latino patients with ASCVD less likely to get optimal care
Click Here to Manage Email Alerts
Key takeaways:
- Since 1999, population-level improvement in use of lipid-lowering drugs and cholesterol control was observed.
- Rates of optimal care were lower among Black and Hispanic/Latino patients vs. white patients.
Despite population-wide improvements in use of lipid-lowering medication and cholesterol control since 1999, significant racial and ethnic disparities persist among patients with a history of atherosclerotic CVD, researchers reported.
“Evidence-based secondary prevention guidelines recommend the use of lifestyle modifications and pharmacological medications to reduce risk factors such as hypertension, dyslipidemia and diabetes. However, previous studies have shown substantial racial and ethnic disparities in adherence to these guidelines, with non-Hispanic Black patients and Hispanic and Latino patients being less likely to achieve cardiovascular risk factor control goals compared with non-Hispanic white patients,” Yuan Lu, ScD, assistant professor of medicine (cardiology), biomedical informatics and data science, and epidemiology (chronic diseases) at Yale New Haven Hospital, and colleagues wrote in JAMA Network Open. “Given the national efforts to eliminate health disparities and the American Heart Association’s goal to champion health equity and advance cardiovascular health for all, it is crucial to assess how much progress has been made in eliminating disparities in guideline-recommended therapies for secondary prevention among patients with ASCVD.”
To this end, Lu and colleagues used National Health and Nutrition Examination Survey data collected from 1999 to March 2020.
The present analysis included 5,218 adults with a history of ASCVD (mean age, 66 years; 44% women). Overall, 11.6% were Black, 7.7% were Hispanic or Latino and 80.7% were white.
Among patients with a history of ASCVD, the age-adjusted rate of lipid-lowering medications from 1999 to 2004 was 39.3% among Black individuals, 40.1% among Hispanic and Latino individuals and 52.9% among white individuals.
The researchers reported an increase in the use of lipid-lowering medications and rate of controlled cholesterol among all racial and ethnic subgroups from 1999 to 2020; however, there was no significant change in the observed differences in treatment and rates of controlled cholesterol between white and Black individuals and white and Hispanic and Latino individuals.
From 2017 to 2020, use of lipid-lowering medications remained lower among Black individuals (24.07 percentage points; 95% CI, 29.12 to 14.52; P < .001) and Hispanic and Latino individuals (17.56 percentage points; 95% CI, 29.12 to 5.99; P = .005) compared with white individuals.
Moreover, from 2017 to 2020, optimal care defined as eligible patients being treated with aspirin, cholesterol-lowering medication and antihypertensive medication were observed in 47.4% of Black individuals (95% CI, 39.3-55.4), 48.7% of Hispanic and Latino individuals (95% CI, 36.7-60.6) and 53% of white individuals (95% CI, 45.6-60.4), according to the study.
“In this cross-sectional study of U.S. adults with ASCVD, significant disparities have persisted between current care and optimal care, surpassing any differences observed among demographic groups,” the researchers wrote. “Our findings highlight the critical need for sustained efforts to bridge these gaps and achieve better outcomes for all patients, regardless of their racial and ethnic backgrounds.”
Collapse
Click Here to Manage Email Alerts