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Heart Disease and Stroke Statistics-2018 Update: A Report From the American Heart Association.
Benjamin EJ, Virani SS, Callaway CW, Chamberlain AM, Chang AR, Cheng S, Chiuve SE, Cushman M, Delling FN, Deo R, de Ferranti SD, Ferguson JF, Fornage M, Gillespie C, Isasi CR, Jiménez MC, Jordan LC, Judd SE, Lackland D, Lichtman JH, Lisabeth L, Liu S, Longenecker CT, Lutsey PL, Mackey JS, Matchar DB, Matsushita K, Mussolino ME, Nasir K, O'Flaherty M, Palaniappan LP, Pandey A, Pandey DK, Reeves MJ, Ritchey MD, Rodriguez CJ, Roth GA, Rosamond WD, Sampson UKA, Satou GM, Shah SH, Spartano NL, Tirschwell DL, Tsao CW, Voeks JH, Willey JZ, Wilkins JT, Wu JH, Alger HM, Wong SS, Muntner P, American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee
(2018) Circulation 137: e67-e492
MeSH Terms: American Heart Association, Comorbidity, Data Interpretation, Statistical, Health Status, Heart Diseases, Humans, Life Style, Prognosis, Risk Assessment, Risk Factors, Stroke, United States
Added April 2, 2019
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1 Members
0 Resources
12 MeSH Terms
Health disparities among adult patients with a phenotypic diagnosis of familial hypercholesterolemia in the CASCADE-FH™ patient registry.
Amrock SM, Duell PB, Knickelbine T, Martin SS, O'Brien EC, Watson KE, Mitri J, Kindt I, Shrader P, Baum SJ, Hemphill LC, Ahmed CD, Andersen RL, Kullo IJ, McCann D, Larry JA, Murray MF, Fishberg R, Guyton JR, Wilemon K, Roe MT, Rader DJ, Ballantyne CM, Underberg JA, Thompson P, Duffy D, Linton MF, Shapiro MD, Moriarty PM, Knowles JW, Ahmad ZS
(2017) Atherosclerosis 267: 19-26
MeSH Terms: Adult, African Americans, Aged, Asian Americans, Cardiovascular Diseases, Cholesterol, HDL, Cholesterol, LDL, Ethnic Groups, Female, Health Status Disparities, Healthcare Disparities, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Hyperlipoproteinemia Type II, Male, Middle Aged, Multicenter Studies as Topic, Odds Ratio, Phenotype, Prospective Studies, Registries, Retrospective Studies, Risk Factors, Sex Factors
Show Abstract · Added April 10, 2018
BACKGROUND AND AIMS - Most familial hypercholesterolemia (FH) patients remain undertreated, and it is unclear what role health disparities may play for FH patients in the US. We sought to describe sex and racial/ethnic disparities in a national registry of US FH patients.
METHODS - We analyzed data from 3167 adults enrolled in the CAscade SCreening for Awareness and DEtection of Familial Hypercholesterolemia (CASCADE-FH) registry. Logistic regression was used to evaluate for disparities in LDL-C goals and statin use, with adjustments for covariates including age, cardiovascular risk factors, and statin intolerance.
RESULTS - In adjusted analyses, women were less likely than men to achieve treated LDL-C of <100 mg/dL (OR 0.68, 95% CI, 0.57-0.82) or ≥50% reduction from pretreatment LDL-C (OR 0.79, 95% CI, 0.65-0.96). Women were less likely than men to receive statin therapy (OR, 0.60, 95% CI, 0.50-0.73) and less likely to receive a high-intensity statin (OR, 0.60, 95% CI, 0.49-0.72). LDL-C goal achievement also varied by race/ethnicity: compared with whites, Asians and blacks were less likely to achieve LDL-C levels <100 mg/dL (Asians, OR, 0.47, 95% CI, 0.24-0.94; blacks, OR, 0.49, 95% CI, 0.32-0.74) or ≥50% reduction from pretreatment LDL-C (Asians, OR 0.56, 95% CI, 0.32-0.98; blacks, OR 0.62, 95% CI, 0.43-0.90).
CONCLUSIONS - In a contemporary US population of FH patients, we identified differences in LDL-C goal attainment and statin usage after stratifying the population by either sex or race/ethnicity. Our findings suggest that health disparities contribute to the undertreatment of US FH patients. Increased efforts are warranted to raise awareness of these disparities.
Copyright © 2017 Elsevier B.V. All rights reserved.
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24 MeSH Terms
Ideal Cardiovascular Health, Cardiovascular Remodeling, and Heart Failure in Blacks: The Jackson Heart Study.
Spahillari A, Talegawkar S, Correa A, Carr JJ, Terry JG, Lima J, Freedman JE, Das S, Kociol R, de Ferranti S, Mohebali D, Mwasongwe S, Tucker KL, Murthy VL, Shah RV
(2017) Circ Heart Fail 10:
MeSH Terms: Adult, African Americans, Aged, Blood Glucose, Blood Pressure, Comorbidity, Diabetes Mellitus, Exercise, Female, Health Status Disparities, Heart Failure, Humans, Hypertension, Incidence, Kaplan-Meier Estimate, Magnetic Resonance Imaging, Cine, Male, Middle Aged, Mississippi, Prospective Studies, Risk Assessment, Risk Factors, Risk Reduction Behavior, Sedentary Behavior, Smoking, Smoking Cessation, Smoking Prevention, Ventricular Function, Left, Ventricular Remodeling
Show Abstract · Added September 11, 2017
BACKGROUND - The lifetime risk of heart failure (HF) is higher in the black population than in other racial groups in the United States.
METHODS AND RESULTS - We measured the Life's Simple 7 ideal cardiovascular health metrics in 4195 blacks in the JHS (Jackson Heart Study; 2000-2004). We evaluated the association of Simple 7 metrics with incident HF and left ventricular structure and function by cardiac magnetic resonance (n=1188). Mean age at baseline was 54.4 years (65% women). Relative to 0 to 2 Simple 7 factors, blacks with 3 factors had 47% lower incident HF risk (hazard ratio [HR], 0.53; 95% confidence interval [CI], 0.39-0.73; <0.0001); and those with ≥4 factors had 61% lower HF risk (HR, 0.39; 95% CI, 0.24-0.64; =0.0002). Higher blood pressure (HR, 2.32; 95% CI, 1.28-4.20; =0.005), physical inactivity (HR, 1.65; 95% CI, 1.07-2.55; =0.02), smoking (HR, 2.04; 95% CI, 1.43-2.91; <0.0001), and impaired glucose control (HR, 1.76; 95% CI, 1.34-2.29; <0.0001) were associated with incident HF. The age-/sex-adjusted population attributable risk for these Simple 7 metrics combined was 37.1%. Achievement of ideal blood pressure, ideal body mass index, ideal glucose control, and nonsmoking was associated with less likelihood of adverse cardiac remodeling by cardiac magnetic resonance.
CONCLUSIONS - Cardiovascular risk factors in midlife (specifically elevated blood pressure, physical inactivity, smoking, and poor glucose control) are associated with incident HF in blacks and represent targets for intensified HF prevention.
© 2017 American Heart Association, Inc.
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29 MeSH Terms
DEVELOPMENT AND PERFORMANCE OF TEXT-MINING ALGORITHMS TO EXTRACT SOCIOECONOMIC STATUS FROM DE-IDENTIFIED ELECTRONIC HEALTH RECORDS.
Hollister BM, Restrepo NA, Farber-Eger E, Crawford DC, Aldrich MC, Non A
(2017) Pac Symp Biocomput 22: 230-241
MeSH Terms: Algorithms, Computational Biology, Data Mining, Electronic Health Records, Female, Health Status, Humans, Male, Social Class
Show Abstract · Added May 5, 2017
Socioeconomic status (SES) is a fundamental contributor to health, and a key factor underlying racial disparities in disease. However, SES data are rarely included in genetic studies due in part to the difficultly of collecting these data when studies were not originally designed for that purpose. The emergence of large clinic-based biobanks linked to electronic health records (EHRs) provides research access to large patient populations with longitudinal phenotype data captured in structured fields as billing codes, procedure codes, and prescriptions. SES data however, are often not explicitly recorded in structured fields, but rather recorded in the free text of clinical notes and communications. The content and completeness of these data vary widely by practitioner. To enable gene-environment studies that consider SES as an exposure, we sought to extract SES variables from racial/ethnic minority adult patients (n=9,977) in BioVU, the Vanderbilt University Medical Center biorepository linked to de-identified EHRs. We developed several measures of SES using information available within the de-identified EHR, including broad categories of occupation, education, insurance status, and homelessness. Two hundred patients were randomly selected for manual review to develop a set of seven algorithms for extracting SES information from de-identified EHRs. The algorithms consist of 15 categories of information, with 830 unique search terms. SES data extracted from manual review of 50 randomly selected records were compared to data produced by the algorithm, resulting in positive predictive values of 80.0% (education), 85.4% (occupation), 87.5% (unemployment), 63.6% (retirement), 23.1% (uninsured), 81.8% (Medicaid), and 33.3% (homelessness), suggesting some categories of SES data are easier to extract in this EHR than others. The SES data extraction approach developed here will enable future EHR-based genetic studies to integrate SES information into statistical analyses. Ultimately, incorporation of measures of SES into genetic studies will help elucidate the impact of the social environment on disease risk and outcomes.
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9 MeSH Terms
Higher protein intake is associated with increased risk for incident end-stage renal disease among blacks with diabetes in the Southern Community Cohort Study.
Malhotra R, Cavanaugh KL, Blot WJ, Ikizler TA, Lipworth L, Kabagambe EK
(2016) Nutr Metab Cardiovasc Dis 26: 1079-1087
MeSH Terms: Adult, African Americans, Aged, Case-Control Studies, Databases, Factual, Diabetic Nephropathies, Dietary Proteins, Energy Intake, European Continental Ancestry Group, Feeding Behavior, Female, Health Status Disparities, Humans, Incidence, Kidney Failure, Chronic, Logistic Models, Male, Middle Aged, Odds Ratio, Prospective Studies, Recommended Dietary Allowances, Risk Assessment, Risk Factors, Surveys and Questionnaires, Time Factors, United States
Show Abstract · Added September 17, 2016
BACKGROUND AND AIMS - Diabetes, a risk factor for end-stage renal disease (ESRD), is associated with impaired protein metabolism. We investigated whether protein intake is associated with ESRD and whether the risk is higher among blacks with diabetes.
METHODS AND RESULTS - We conducted a nested case-control study of ESRD within the Southern Community Cohort Study, a prospective study of low-income blacks and whites in the southeastern US (2002-2009). Through 2012, 1057 incident ESRD cases were identified by linkage with the United States Renal Data System and matched to 3198 controls by age, sex, and race. Dietary intakes were assessed from a validated food frequency questionnaire at baseline. Odds ratios (ORs) and 95% confidence intervals (CIs) were computed from logistic regression models that included matching variables, BMI, education, income, hypertension, total energy intake, and percent energy from saturated and polyunsaturated fatty acids. Mean (±SD) daily energy intake from protein was higher among ESRD cases than controls (15.7 ± 3.3 vs. 15.1 ± 3.1%, P < 0.0001). For a 1% increase in percent energy intake from protein, the adjusted ORs (95% CIs) for ESRD were 1.06 (1.02-1.10) for blacks with diabetes, 1.02 (0.98-1.06) for blacks without diabetes, 0.99 (0.90-1.09) for whites with diabetes and 0.94 (0.84-1.06) for whites without diabetes. Protein intake in g/kg/day was also associated with ESRD (4th vs. 1st quartile OR = 1.76; 95% CI: 1.17-2.65).
CONCLUSION - Our results raise the possibility that among blacks with diabetes, increased dietary protein is associated with increased incidence of ESRD. Studies on how protein intake and metabolism affect ESRD are needed.
Copyright © 2016 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.
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26 MeSH Terms
Tumor Characteristics, Genetics, Management, and the Risk of Metastasis in Uveal Melanoma.
Nichols EE, Richmond A, Daniels AB
(2016) Semin Ophthalmol 31: 304-9
MeSH Terms: Health Status Disparities, Humans, Melanoma, Neoplasm Metastasis, Risk Factors, Survival Rate, Uveal Neoplasms
Show Abstract · Added January 4, 2017
Uveal melanoma is the most common intraocular malignancy in adults. Although rates of local control for uveal melanoma exceed 95% with radiotherapy or enucleation, as many as 50% of patients develop hematogenous metastases, which manifest in the decades following initial diagnosis and are uniformly and rapidly fatal. Recent compelling evidence suggests that not all uveal melanomas are themselves equivalent with respect to metastatic potential and patient survival. This review focuses on the mounting evidence of survival disparities based on intrinsic tumor clinical and histopathologic characteristics and based on tumor genetics and gene expression profiles.
2 Communities
1 Members
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7 MeSH Terms
Glaucoma Disparities in the Hispanic Population.
Nathan N, Joos KM
(2016) Semin Ophthalmol 31: 394-9
MeSH Terms: Glaucoma, Health Services, Health Services Accessibility, Health Status Disparities, Hispanic Americans, Humans, Risk Factors
Show Abstract · Added March 19, 2018
The Hispanic population is the United States' largest minority and one of the fastest growing as well. In the next 30 to 40 years, the proportion of open-angle glaucoma patients represented by Hispanics is expected to dramatically rise. Here we examine the unique considerations and challenges of glaucoma care in this population, from demographics to risk factors to treatments and outcomes. Currently, access to care and the under-diagnosis of glaucoma in this population are significant issues that look only to grow in significance as the glaucoma burden continues to grow. Additionally, utilization of medical and surgical therapy remains lower in Hispanics than in many other ethnic groups. Understanding and proactively addressing the unique challenges in the screening and treatment of Hispanics will be of utmost importance to providing effective care to this population.
0 Communities
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7 MeSH Terms
Disparities in Uveal Melanoma: Patient Characteristics.
Nichols EE, Richmond A, Daniels AB
(2016) Semin Ophthalmol 31: 296-303
MeSH Terms: Health Status Disparities, Humans, Melanoma, Neoplasm Metastasis, Risk Factors, Survival Rate, Uveal Neoplasms
Show Abstract · Added January 4, 2017
Uveal melanoma is the most common intraocular malignancy in adults. Despite excellent rates of local control, half of all patients with uveal melanoma ultimately go on to develop fatal metastatic disease. This review focuses on disparities and differences in the underlying characteristics of the patients, and how these patient characteristics impact the development of metastasis and subsequent patient survival. Specifically, we detail disparities in epidemiology and risk factors as they relate to the development of primary uveal melanoma, to the development of metastasis, and to patient survival following metastasis.
2 Communities
1 Members
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7 MeSH Terms
Eye Care Disparities and Health-Related Consequences in Elderly Patients with Age-Related Eye Disease.
Umfress AC, Brantley MA
(2016) Semin Ophthalmol 31: 432-8
MeSH Terms: Aged, Aged, 80 and over, Aging, Eye Diseases, Health Services Accessibility, Health Status, Healthcare Disparities, Humans, Vision Disorders, Visually Impaired Persons
Show Abstract · Added February 23, 2017
The elderly population in the United States (age 65 and older) is growing rapidly, estimated by the U.S. Census Department to reach 83.7 million by 2050.(1) Visual impairment increases with age among all racial and ethnic groups.(2) In the elderly, the most common culprits for vision loss are cataract, glaucoma, and age-related macular degeneration (AMD).(2) In the developed world, vision loss from cataract has been dramatically reduced by increased access to cataract surgery. However, AMD and glaucoma lead to irreversible vision loss without early diagnosis and intervention. In the U.S., cases of AMD are expected to double by 2050, reaching 17.8 million among patients age 50 or older.(3) Similarly, cases of glaucoma are expected to reach 5.5 million by 2050, an increase of over 90% from 2014.(3) The visually impaired elderly face disparities in access to eye care, and subsequent general medical and psychosocial complications.
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10 MeSH Terms
Socioeconomic Disparities in Cataract Prevalence, Characteristics, and Management.
Mundy KM, Nichols E, Lindsey J
(2016) Semin Ophthalmol 31: 358-63
MeSH Terms: Cataract, Cataract Extraction, Health Status Disparities, Humans, Prevalence, Social Class, Vision Disorders
Show Abstract · Added August 31, 2017
PURPOSE - To review the current literature on socioeconomic disparities relationship with cataract prevalence, characteristics, and management.
SUMMARY - Cataracts are an important cause of preventable visual impairment in both the developing and industrialized world. Cataract surgery is a highly effective operation with an excellent risk profile. Furthermore, cataract surgery has been shown to have significant positive functional, social, and economic implications for patients. Several medical conditions have been shown to have correlation with socioeconomic factors and cataract is among several forms of visual impairment that demonstrate this relationship. Disparities in prevalence, clinical characteristics, and management are documented in the ophthalmic literature. A better understanding of these socioeconomic factors and their clinical relevance is critical to alleviating the burden of cataract-related visual impairment in an aging population.
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7 MeSH Terms