National Healthcare Quality and Disparities Report
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 41 Research Studies DisplayedEngelberg RS, Scheidell JD, Islam N
Associations between incarceration history and risk of hypertension and hyperglycemia: consideration of differences among Black, Hispanic, Asian and White Subgroups.
This study’s objective was to assess racial/ethnic group differences in the association between incarceration and hypertension and hyperglycemia. The authors performed a secondary data analysis using the National Longitudinal Survey of Adolescent to Adult Health (Add Health). They used Poisson regression to estimate the associations between lifetime history of incarceration reported during early adulthood with hypertension and hyperglycemia outcomes measured in mid-adulthood, including incident diagnosis. They evaluated whether associations varied by self-reported race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic, and Asian) with an analytic sample of 4,015 Add Health respondents. Outcome measures included hypertension, systolic blood pressure >130 mmHG, and hyperglycemia. There was no evidence of an association between incarceration and measured health outcomes among non-Hispanic Black and non-Hispanic White participants. Among Hispanic participants, incarceration was associated with hyperglycemia (Adjusted Risk Ratio (ARR): 2.1), but not with hypertension risk. Incarceration was associated with elevated systolic blood pressure (ARR: 3.1) and hypertension (ARR: 1.7) among Asian participants, but not with hyperglycemia risk. Incarceration was associated with incident hypertension (ARR 2.5) among Asian subgroups.
AHRQ-funded; HS026120.
Citation: Engelberg RS, Scheidell JD, Islam N .
Associations between incarceration history and risk of hypertension and hyperglycemia: consideration of differences among Black, Hispanic, Asian and White Subgroups.
J Gen Intern Med 2024 Jan; 39(1):5-12. doi: 10.1007/s11606-023-08327-9..
Keywords: Vulnerable Populations, Racial and Ethnic Minorities, Blood Pressure, Cardiovascular Conditions, Risk
O'Donnell TFX,, Dansey KD, Marcaccio CL
Racial disparities in treatment of ruptured abdominal aortic aneurysms.
This study evaluated regional center transfer rates, turndown rates, and outcomes for Black vs White patients presenting with ruptured abdominal aortic aneurysms (rAAAs) in two large databases. All rAAA repairs in the Vascular Quality Initiative from 2003 to 2020 was used. The authors used the National Inpatient Sample from 2004 to 2015 to examine turndown rates for repair. They identified 4935 patients with rAAAs in the Vascular Quality Initiative (6.2% Black) and 48,489 in the National Inpatient Sample (6.0% Black). Transfer rates were high; however, Black patients were significantly less likely to undergo transfer before repair compared with White patients (49% Black vs 62% White). No significant differences were found in perioperative mortality or complications. However, Black patients were significantly more likely to be turned down for repair (37% vs 28%). This difference was mostly found to be due to insurance status. Patients with private insurance had undergone surgery at a similar rate. However, among patients with Medicare or Medicaid/self-pay, Black patients were less likely than were White patients to undergo repair (Medicare, 64% vs 72%; Medicaid/self-pay, 43% vs 61%). Medicaid/self-pay patients were less likely to undergo repair than were patients of the same race with either Medicare or private insurance.
AHRQ-funded; HS027285.
Citation: O'Donnell TFX,, Dansey KD, Marcaccio CL .
Racial disparities in treatment of ruptured abdominal aortic aneurysms.
J Vasc Surg 2023 Feb; 77(2):406-14. doi: 10.1016/j.jvs.2022.08.009..
Keywords: Healthcare Cost and Utilization Project (HCUP), Disparities, Racial and Ethnic Minorities, Cardiovascular Conditions
Stockdill ML, Dionne-Odom JN, Wells R
African American recruitment in early heart failure palliative care trials: outcomes and comparison with the ENABLE CHF-PC randomized trial.
This study examined African American (AA) clinical trial recruitment and enrollment in a palliative care randomized controlled trial (RCT) for heart failure (HF) patients and compared patient baseline characteristics to other HF palliative care RCTs. The authors used the ENABLE CHF-PC (Educate, Nurture, Advise, Before Life Ends: Comprehensive Heartcare for Patients and Caregivers) RCT using bivariate statistics to compare racial and patient characteristics and differences through recruitment stages. They then compared the baseline sample characteristics among three palliative HF trials. They screened 785 patients, of whom 566 with NYHA classification III-IV were approached, with 461 enrolled and then 415 randomized. African Americans were more likely to consent than Caucasians (55%), were younger, had a lower ejection fraction, were more likely to be single, and lack an advanced directive. AAs reported higher goal setting, care coordination, and used more “denial” coping strategies. Compared to two recent HF RCTs, the ENABLE CHF-PC sample had a higher proportion of AAs.
AHRQ-funded; HS013852.
Citation: Stockdill ML, Dionne-Odom JN, Wells R .
African American recruitment in early heart failure palliative care trials: outcomes and comparison with the ENABLE CHF-PC randomized trial.
J Palliat Care 2023 Jan;38(1):52-61. doi: 10.1177/0825859720975978..
Keywords: Racial and Ethnic Minorities, Palliative Care, Heart Disease and Health, Cardiovascular Conditions
de Guerre L, Rice J, Cheng J
Racial differences in isolated aortic, concomitant aortoiliac, and isolated iliac aneurysms: this is a retrospective observational study.
The purpose of this research was to investigate racial and ethnic disparities in the clinical presentation, foundational and operative features, and outcomes following aortoiliac aneurysm repair. Prior research has revealed variations in the incidence of abdominal aortic aneurysms across racial and ethnic groups, along with more intricate iliac anatomical structures in Asian individuals. The researchers analyzed White, Black, Asian, and Hispanic patients who underwent aortoiliac aneurysm repair in the VQI between 2003 and 2019, and examined baseline comorbidities, operative attributes, and perioperative outcomes according to race and ethnicity. They study found that within the 60,435-patient sample, Black and Asian patients were most likely to receive repair for aortoiliac and isolated iliac aneurysms, while White and Hispanic patients predominantly underwent isolated aortic aneurysm repair. Black patients were more prone to symptomatic repair and experienced rupture repair at a reduced aortic diameter. The iliac aneurysm diameter was largest in Black and Asian patients. Asian individuals were most likely to exhibit aortic neck angulation greater than 60 degrees, over 20% graft oversizing, and postoperative endoleaks. Additionally, Asian patients had a higher likelihood of hypogastric artery aneurysm and hypogastric coiling procedures. The study concluded that Asian and Black patients demonstrated a higher likelihood of undergoing repair for aortoiliac and isolated iliac aneurysms, while White and Hispanic patients predominantly received repair for isolated aortic aneurysms.
AHRQ-funded; HS027285
Citation: de Guerre L, Rice J, Cheng J .
Racial differences in isolated aortic, concomitant aortoiliac, and isolated iliac aneurysms: this is a retrospective observational study.
Ann Surg 2023 Jan 1;277(1):165-72. doi: 10.1097/sla.0000000000004731.
Keywords: Racial and Ethnic Minorities, Cardiovascular Conditions
Marcaccio CL, Patel PB, de Guerre L
Disparities in 5-year outcomes and imaging surveillance following elective endovascular repair of abdominal aortic aneurysm by sex, race, and ethnicity.
The purpose of this study was to identify variations in 5-year outcomes and imaging surveillance after elective endovascular aortic aneurysm repair (EVAR) by sex, race, and ethnicity and to examine possible mechanisms contributing to these variations. The primary outcome was 5-year aneurysm rupture. Secondary outcomes were 5-year reintervention and mortality, and having no aortic imaging follow-up from 6 to 24 months after EVAR. The study found that among 16,040 patients, 73% were White males, 18% were White females, 2.6% were Black males, 1.1% were Black females, 0.9% were Asian males, 0.2% were Asian females, 1.7% were Hispanic males, and 0.4% were Hispanic females. At 5 years, Black females had the highest rupture rates at 6.4% and white males had the lowest at 2.3%. Compared with White males, rupture rates were higher in White females, Black females, and Asian females. Among other groups, Black males had higher reintervention and both Black and Hispanic males had higher rates of no imaging follow-up. In adjusted analyses, White, Black, and Asian females remained at significantly higher risk for 5-year rupture. The researchers concluded that Black females had higher 5-year aneurysm rupture, reintervention, and mortality rates after elective EVAR as compared with White male patients, whereas White females had higher rupture, mortality and loss-to-imaging-follow-up compared to White male patients. Black males had higher reintervention and no imaging follow-up, and Asian females had higher rupture rates.
AHRQ-funded; HS027285.
Citation: Marcaccio CL, Patel PB, de Guerre L .
Disparities in 5-year outcomes and imaging surveillance following elective endovascular repair of abdominal aortic aneurysm by sex, race, and ethnicity.
J Vasc Surg 2022 Nov;76(5):1205-15.e4. doi: 10.1016/j.jvs.2022.03.886..
Keywords: Disparities, Racial and Ethnic Minorities, Sex Factors, Outcomes, Imaging, Heart Disease and Health, Cardiovascular Conditions
Marcaccio CL, O'Donnell TFX, Dansey KD
Disparities in reporting and representation by sex, race, and ethnicity in endovascular aortic device trials.
The purpose of this study was to examine the demographics of patients enrolled in critical U.S. endovascular aortic device trials to explore the representation of vulnerable populations, including women and racial and ethnic minorities. The primary outcomes included the percentage of trials reporting participant sex, race, and ethnicity and the percentage of participants across sex, racial, and ethnic groups. The study found that the Food and Drug Administration (FDA) provided 29 approvals from 29 trials of 24 devices with a total of 4046 patients: 52% (15) were EVAR devices, 41% (12) were TEVAR devices, and 3.4% (1) was a FEVAR device, with 1 dissection stent (3.4%). Fifty-two percent of the trials reported the three most common racial groups (White, Black, Asian), and 48% reported Hispanic ethnicity. The TEVAR trials were the most likely to report all three racial groups and Hispanic ethnicity (92% and 75%, respectively), while the EVAR trials had the lowest reporting rates (13% and 20%, respectively). The median female enrollment was 21%, with the EVAR trials having the lowest female enrollment compared with 41% in the TEVAR trials, 21% in the FEVAR trial, and 34% in the dissection stent trial. The study concluded that in critical aortic device trials that led to FDA approval, female patients were underrepresented, especially for EVAR, and racial and ethnic minority groups were under-represented and underreported.
AHRQ-funded; HS027285.
Citation: Marcaccio CL, O'Donnell TFX, Dansey KD .
Disparities in reporting and representation by sex, race, and ethnicity in endovascular aortic device trials.
J Vasc Surg 2022 Nov;76(5):1244-52.e2. doi: 10.1016/j.jvs.2022.05.003..
Keywords: Disparities, Racial and Ethnic Minorities, Heart Disease and Health, Cardiovascular Conditions, Medical Devices, Sex Factors
Anjorin AC, Marcaccio CL, Patel PB
Racial and ethnic disparities in 3-year outcomes following infrainguinal bypass for chronic limb-threatening ischemia.
This study’s objective was to determine the differences in 3-year outcomes after open infrainguinal bypass for chronic limb-threatening ischemia (CLTI) stratified by race/ethnicity and explored the potential factors contributing to these differences to help determine reasons why outcomes are worse for racial and ethnic minorities. The authors identified all CLTI patients who had undergone primary open infrainguinal bypass in the Vascular Quality Initiative registry from 2003 to 2017 with linkage to Medicare claims through 2018 for the 3-year outcomes. Primary outcomes were the 3-year rates of major amputation, reintervention, and mortality. They also recorded 30-day major adverse limb events (MALE) defined as major amputation or reintervention. Of the 7108 patients with CLTI 79% were non-Hispanic White, 15% were Black, 1% were Asian, and 6% were Hispanic. Compared with White patients, Black patients had higher rates of 3-year major amputation (Black vs White, 32% vs 19%), reintervention (Black vs White, 61% vs 57%), and 30-day MALE (Black vs White, 8.1% vs 4.9%) but lower mortality (Black vs White, 38% vs 42%). Hispanic patients also experienced higher rates of amputation (Hispanic vs White, 27% vs 19%), reintervention (Hispanic vs White, 70% vs 57%), and MALE (Hispanic vs White, 8.7% vs 4.9%). However, mortality was similar between Hispanic vs White groups. A higher presence of comorbidities in Black and Hispanic patients with CLTI is considered the greatest contributing factors to higher amputation and reintervention rates.
AHRQ-funded; HS027285.
Citation: Anjorin AC, Marcaccio CL, Patel PB .
Racial and ethnic disparities in 3-year outcomes following infrainguinal bypass for chronic limb-threatening ischemia.
J Vasc Surg 2022 Nov;76(5):1335-46.e7. doi: 10.1016/j.jvs.2022.06.026..
Keywords: Racial and Ethnic Minorities, Disparities, Outcomes, Surgery, Cardiovascular Conditions
Mallela DP, Canner JK, Zarkowsky DS
Association between race and perioperative outcomes after carotid endarterectomy for asymptomatic carotid artery stenosis in NSQIP.
This study investigated the association of race on carotid endarterectomy (CEA) outcomes. Perioperative outcomes (at 30 days) were compared for Black vs. White patients adjusting for age/sex, comorbidities and disease characteristics. Out of 16,764 patients from the ACS-NSQIP targeted vascular database (2011-2019), 95.2% were White and 4.8% were Black. Black patients were slightly younger and more frequently (79.5% vs 74.0%) had high-grade carotid artery stenosis compared to White patients. Comorbidities including hypertension, diabetes, kidney disease, congestive heart failure, and coronary artery disease were all more prevalent among Black patients. Crude perioperative stroke and stroke/death were higher for Black patients, but myocardial infarction leading to death were similar. After adjusting for baseline differences between groups, the risk of perioperative stroke and stroke/death remained significantly higher for Black patients than White patients.
AHRQ-funded; HS024547.
Citation: Mallela DP, Canner JK, Zarkowsky DS .
Association between race and perioperative outcomes after carotid endarterectomy for asymptomatic carotid artery stenosis in NSQIP.
J Am Coll Surg 2022 Jan;234(1):65-73. doi: 10.1097/xcs.0000000000000016..
Keywords: Racial and Ethnic Minorities, Surgery, Cardiovascular Conditions, Stroke, Risk, Adverse Events
Steinberg RS, Nayak A, Burke MA
Association of race and gender with primary caregiver relationships and eligibility for advanced heart failure therapies.
Caregiver support is considered necessary after heart transplant (HT) and left ventricular assist device (LVAD) for patients with end-stage heart failure (HF). Few studies have demonstrated how caregivers differ by gender and race, and whether that impacts therapy eligibility. In this study, the investigators examined caregiver relationships among 674 patients (32% women, 55% Black) evaluated at Emory University from 2011 to 2017.
AHRQ-funded; HS026081.
Citation: Steinberg RS, Nayak A, Burke MA .
Association of race and gender with primary caregiver relationships and eligibility for advanced heart failure therapies.
Clin Transplant 2022 Jan;36(1):e14502. doi: 10.1111/ctr.14502..
Keywords: Caregiving, Racial and Ethnic Minorities, Heart Disease and Health, Cardiovascular Conditions
Ejem D, Steinhauser K, Dionne-Odom JN
Exploring culturally responsive religious and spirituality health care communications among African Americans with advanced heart failure, their family caregivers, and clinicians.
This study explored how religion and spirituality (R/S) impacts the ways that African Americans (AAs) cope with serious illness. In particular, this study looks at AAs with advanced heart failure and their family caregivers’ (FCGs) preferences about R/S in patient-clinician communication. Transcribed interviews were analyzed to identify emergent themes. AA patient participants (n = 15) were a mean age of 62, 40% female, and 87% had >high school diploma/GED. AA FCGs (n = 14) were a mean age of 58, 93% female, 93% had >high school diploma/GED, and 86% were unemployed. Most caregivers were patients’ spouses/partners. All participants were Protestants. Patients and FCGs perspectives differed in relation to inclusion of R/S in health care communication. Patients felt that R/S should not be discussed in clinical encounters and discussed only if patient initiated. FCGs felt that clinicians’ R/S communication is not a priority, but clinicians should openly acknowledge patients’ R/S beliefs and should engage in R/S conversations with patients.
AHRQ-funded; HS013852.
Citation: Ejem D, Steinhauser K, Dionne-Odom JN .
Exploring culturally responsive religious and spirituality health care communications among African Americans with advanced heart failure, their family caregivers, and clinicians.
J Palliat Med 2021 Dec;24(12):1798-806. doi: 10.1089/jpm.2021.0044..
Keywords: Racial and Ethnic Minorities, Communication, Heart Disease and Health, Cardiovascular Conditions, Caregiving
Hollingsworth JM, Yu X, Yan PL
Provider care team segregation and operative mortality following coronary artery bypass grafting.
The purpose of this study was to examine whether provider care team segregation within hospitals contributes to the higher mortality rate of Black patients following coronary artery bypass grafting compared to their White counterparts. Using national Medicare data, findings showed that Black patients who undergo coronary artery bypass grafting at a hospital with a higher level of provider care team segregation die more frequently after surgery than Black patients treated at a hospital with a lower level.
AHRQ-funded; HS026908.
Citation: Hollingsworth JM, Yu X, Yan PL .
Provider care team segregation and operative mortality following coronary artery bypass grafting.
Circ Cardiovasc Qual Outcomes 2021 May;14(5):e007778. doi: 10.1161/circoutcomes.120.007778..
Keywords: Surgery, Heart Disease and Health, Cardiovascular Conditions, Mortality, Teams, Healthcare Delivery, Racial and Ethnic Minorities
Su CM, Warren A, Kraus C
Lack of racial and ethnic-based differences in acute care delivery in intracerebral hemorrhage.
Int J Emerg Med 2021 Jan 19;14(1):6. doi: 10.1186/s12245-021-00329-w.
Early diagnosis and treatment of intracerebral hemorrhage (ICH) is thought to be critical for improving outcomes. In this study the investigators examined whether racial or ethnic disparities existed in acute care processes in the first hours after ICH. The investigators found no evidence of racial/ethnic disparities in acute care processes or outcomes in ICH. English as first language, however, was associated with slower care processes.
Early diagnosis and treatment of intracerebral hemorrhage (ICH) is thought to be critical for improving outcomes. In this study the investigators examined whether racial or ethnic disparities existed in acute care processes in the first hours after ICH. The investigators found no evidence of racial/ethnic disparities in acute care processes or outcomes in ICH. English as first language, however, was associated with slower care processes.
AHRQ-funded; HS024561.
Citation: Su CM, Warren A, Kraus C .
Lack of racial and ethnic-based differences in acute care delivery in intracerebral hemorrhage.
Int J Emerg Med 2021 Jan 19;14(1):6. doi: 10.1186/s12245-021-00329-w..
Keywords: Racial and Ethnic Minorities, Disparities, Critical Care, Stroke, Cardiovascular Conditions, Outcomes
Patel SA, Krasnow M, Long K
Excess 30-day heart failure readmissions and mortality in black patients increases with neighborhood deprivation.
Researchers examined whether neighborhood environment modifies the disparity in 30-day heart failure (HF) readmissions and mortality between Black and White patients in the Southeastern United States. They created a geocoded retrospective cohort of patients hospitalized for acute HF from 2010-2018 within Emory Healthcare. They found that excess 30-day HF readmissions and mortality were present among Black patients in every neighborhood strata and increased with progressive neighborhood socioeconomic deprivation.
AHRQ-funded; HS026081.
Citation: Patel SA, Krasnow M, Long K .
Excess 30-day heart failure readmissions and mortality in black patients increases with neighborhood deprivation.
Circ Heart Fail 2020 Dec;13(12):e007947. doi: 10.1161/circheartfailure.120.007947..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Hospital Readmissions, Racial and Ethnic Minorities, Mortality, Social Determinants of Health, Low-Income, Disparities
Daniel CM, Davila L, Makris UE
Ethnic disparities in atherosclerotic cardiovascular disease incidence and prevalence among rheumatoid arthritis patients in the United States: a systematic review.
In this systematic review, the authors sought to describe the incidence and prevalence of atherosclerotic cardiovascular disease (ASCVD) stratified by race/ethnicity within the US population of those with rheumatoid arthritis (RA). They found insufficient data on racially/ethnically diverse RA patients and ASCVD outcomes. They recommended that future studies report the prevalence of ASCVD in various races/ethnicities with RA in the United States, as these data would help inform clinicians on how best to manage cardiovascular disease risk in RA.
AHRQ-funded; HS022418.
Citation: Daniel CM, Davila L, Makris UE .
Ethnic disparities in atherosclerotic cardiovascular disease incidence and prevalence among rheumatoid arthritis patients in the United States: a systematic review.
ACR Open Rheumatol 2020 Sep;2(9):525-32. doi: 10.1002/acr2.11170..
Keywords: Disparities, Racial and Ethnic Minorities, Arthritis, Cardiovascular Conditions
Jannat-Khah DP, Khodneva Y, Bryant K
Depressive symptoms do not discriminate: racial and economic influences between time-varying depressive symptoms and mortality among REGARDS participants.
This study examined whether time-varying depressive symptoms (TVDS) predict mortality and if racial and income differences moderate the association in a large cohort. The cohort from the REGARDS study was used to look at that determination. The REGARDS study used community-dwelling U.S. adults aged 45 years or older. They found that there was similar and statistically significant differences with white, black, and low-income ($35,000 or less) participants for the association between TVDS and mortality. High-income participants were found to have a lower hazard.
AHRQ-funded; HS025198.
Citation: Jannat-Khah DP, Khodneva Y, Bryant K .
Depressive symptoms do not discriminate: racial and economic influences between time-varying depressive symptoms and mortality among REGARDS participants.
Ann Epidemiol 2020 Jun;46:31-40.e2. doi: 10.1016/j.annepidem.2020.04.004..
Keywords: Depression, Behavioral Health, Racial and Ethnic Minorities, Cardiovascular Conditions, Cancer, Low-Income, Social Determinants of Health, Mortality
Cuffee YL, Rosal M, Hargraves JL
Does home remedy use contribute to medication nonadherence among Blacks with hypertension?
The objective of this study was to examine home remedy (HR) use among Blacks with hypertension and to determine if home remedy use is correlated with blood pressure and medication adherence. Data was obtained from the TRUST study conducted 2006-2008. Findings showed that the use of HR and the number of HRs used may be associated with medication nonadherence and with higher systolic and diastolic blood pressure among Blacks with hypertension. Recommendations included that health care providers need to be aware of health behaviors that may serve as barriers to medication adherence, such as the use of home remedies.
AHRQ-funded; HS020755.
Citation: Cuffee YL, Rosal M, Hargraves JL .
Does home remedy use contribute to medication nonadherence among Blacks with hypertension?
Ethn Dis 2020 Summer;30(3):451-58. doi: 10.18865/ed.30.3.451..
Keywords: Patient Adherence/Compliance, Medication, Blood Pressure, Racial and Ethnic Minorities, Cardiovascular Conditions
Mefford MT, Goyal P, Howard G
The association of hypertension, hypertension duration, and control with incident heart failure in black and white adults.
Associations between hypertension and some cardiovascular diseases are stronger in black vs white adults. In this study, the investigators examined associations of hypertension, hypertension duration, and control with incident heart failure (HF) in black and white REasons for Geographic And Racial Differences in Stroke study participants (n = 25 770) who were followed for incident HF hospitalization (n = 947) from enrollment in 2003-2007 through 2015.
AHRQ-funded; HS013852.
Citation: Mefford MT, Goyal P, Howard G .
The association of hypertension, hypertension duration, and control with incident heart failure in black and white adults.
J Clin Hypertens 2020 May;22(5):857-66. doi: 10.1111/jch.13856..
Keywords: Blood Pressure, Heart Disease and Health, Cardiovascular Conditions, Racial and Ethnic Minorities
Patel M, Boutin-Foster C, Phillips E
Understanding of cardiovascular disease risk factors among Bangladeshi immigrants in New York City.
This study’s objective was to compare the understanding of cardiovascular disease (CVD) risk factors among Bangladeshi immigrants to the general Caucasian population in the U.S. by surveying a sample group of immigrants in Queens, NY., Scores on the knowledge instrument used for the surveyed Bangladeshis were compared with Caucasians from the Coronary Artery Risk Development in Young Adults (CARDIA) study using multivariate regression modeling. The results of the study indicate that understanding of CVD risk factors was lower among Bangladeshis than whites, driven by the surveyed Bangladeshis having less awareness of how exercise and weight contribute to CVD risk. The authors recommend that community based interventions and health partnerships target these behavioral risk factors in the Bangladeshi population.
AHRQ-funded; HS000066.
Citation: Patel M, Boutin-Foster C, Phillips E .
Understanding of cardiovascular disease risk factors among Bangladeshi immigrants in New York City.
Ethn Health 2019 May;24(4):432-42. doi: 10.1080/13557858.2017.1346191..
Keywords: Cardiovascular Conditions, Racial and Ethnic Minorities, Risk, Urban Health
Chen LM, Nallamothu BK, Spertus JA
Racial differences in long-term outcomes among older survivors of in-hospital cardiac arrest.
Black patients have worse in-hospital survival than white patients after in-hospital cardiac arrest (IHCA), but less is known about longterm outcomes. In this study, the investigators sought to assess among IHCA survivors whether there are additional racial differences in survival after hospital discharge and to explore potential reasons for differences. The investigators determined that black survivors of IHCA have lower long-term survival compared with white patients, and about half of this difference is not explained by patient factors or treatments after IHCA.
AHRQ-funded; HS020671; HS024698.
Citation: Chen LM, Nallamothu BK, Spertus JA .
Racial differences in long-term outcomes among older survivors of in-hospital cardiac arrest.
Circulation 2018 Oct 16;138(16):1643-50. doi: 10.1161/circulationaha.117.033211..
Keywords: Cardiovascular Conditions, Elderly, Racial and Ethnic Minorities, Outcomes
Angraal S, Khera R, Wang Y
Sex and race differences in the utilization and outcomes of coronary artery bypass grafting among Medicare beneficiaries, 1999-2014.
The authors sought to evaluate how the use of coronary artery bypass grafting (CABG) and its outcomes have evolved in different sex and racial subgroups. Using Medicare data, they found that women and black patients had persistently higher CABG mortality than men and white patients, respectively, despite greater declines over the time period. The authors conclude that these findings indicate progress, but further progress is needed.
AHRQ-funded; HS023000.
Citation: Angraal S, Khera R, Wang Y .
Sex and race differences in the utilization and outcomes of coronary artery bypass grafting among Medicare beneficiaries, 1999-2014.
J Am Heart Assoc 2018 Jul 12;7(14). doi: 10.1161/jaha.118.009014..
Keywords: Cardiovascular Conditions, Elderly, Evidence-Based Practice, Heart Disease and Health, Healthcare Utilization, Medicare, Outcomes, Patient-Centered Outcomes Research, Racial and Ethnic Minorities, Sex Factors
Lee AK, Lee CJ, Huang ES
Risk factors for severe hypoglycemia in black and white adults with diabetes: the Atherosclerosis Risk in Communities (ARIC) study.
Severe hypoglycemia is a rare but important complication of type 2 diabetes. Few studies have examined the epidemiology of hypoglycemia in a community-based population. This study concluded that poor glycemic control, glycemic variability as captured by 1,5-anhydroglucitol, kidney damage, and measures of cognitive and functional impairments were strongly associated with increased risk of severe hypoglycemia.
AHRQ-funded; HS018542.
Citation: Lee AK, Lee CJ, Huang ES .
Risk factors for severe hypoglycemia in black and white adults with diabetes: the Atherosclerosis Risk in Communities (ARIC) study.
Diabetes Care 2017 Dec;40(12):1661-67. doi: 10.2337/dc17-0819.
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Keywords: Cardiovascular Conditions, Elderly, Diabetes, Racial and Ethnic Minorities, Risk
Musey PI, Jr., Kline JA
Do gender and race make a difference in acute coronary syndrome pretest probabilities in the emergency department?
The objective was to test for significant differences in subjective and objective pretest probabilities for acute coronary syndrome (ACS) in chest pain patients. Despite consistently estimating the risk for ACS to be lower for both females and minorities concordantly with calculated objective pretest assessments, there does not appear to have been any significant decrease in subsequent evaluation of these perceived lower-risk groups when radiation exposure and costs are taken into account.
AHRQ-funded; HS018519.
Citation: Musey PI, Jr., Kline JA .
Do gender and race make a difference in acute coronary syndrome pretest probabilities in the emergency department?
Acad Emerg Med 2017 Feb;24(2):142-51. doi: 10.1111/acem.13131.
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Keywords: Sex Factors, Racial and Ethnic Minorities, Cardiovascular Conditions, Emergency Medical Services (EMS)
Shafi T, Powe NR, Meyer TW
Trimethylamine N-oxide and cardiovascular events in hemodialysis patients.
This study determined the association of the proatherogenic metabolite trimethylamine N-oxide (TMAO) with cardiovascular outcomes in hemodialysis patients and assessed whether this association differs by race. It found that, compared with blacks in the same quintile, whites in the highest quintile for TMAO (>/=135 muM) had a 4-fold higher risk of cardiac or sudden cardiac death and a 2-fold higher risk of any-cause death.
AHRQ-funded; HS008365.
Citation: Shafi T, Powe NR, Meyer TW .
Trimethylamine N-oxide and cardiovascular events in hemodialysis patients.
J Am Soc Nephrol 2017 Jan;28(1):321-31. doi: 10.1681/asn.2016030374.
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Keywords: Kidney Disease and Health, Racial and Ethnic Minorities, Cardiovascular Conditions
Womack VY, De Chavez PJ, Albrecht SS
A longitudinal relationship between depressive symptoms and development of metabolic syndrome: the Coronary Artery Risk Development in Young Adults study.
The researchers tested whether baseline and time-varying depressive symptoms were associated with metabolic syndrome incidence in black and white men and women from the Coronary Artery Risk Development in Young Adults study. They found that, over 15 years, the incidence rate of metabolic syndrome varied by race and sex, with the highest rate in black women followed by white men, black men, and white women. Depressive symptoms were associated with incident metabolic syndrome in white men and white women. However, they found no significant association between depression and metabolic syndrome among black men or black women.
AHRQ-funded; HS023009.
Citation: Womack VY, De Chavez PJ, Albrecht SS .
A longitudinal relationship between depressive symptoms and development of metabolic syndrome: the Coronary Artery Risk Development in Young Adults study.
Psychosom Med 2016 Sep;78(7):867-73. doi: 10.1097/psy.0000000000000347.
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Keywords: Cardiovascular Conditions, Depression, Racial and Ethnic Minorities, Sex Factors, Young Adults
Adedinsewo D, Taka N, Agasthi P
Prevalence and factors associated with statin use among a nationally representative sample of US Adults: National Health and Nutrition Examination Survey, 2011-2012.
The researchers estimated the prevalence and likelihood of statin use among a statin benefit group with diabetes and a second group with arteriosclerosis. In adjusted models, uninsured and Hispanic adults were less likely to be on a statin compared with white adults; 59.5 percent of all adults in the diabetes statin benefit group, and 63.5 percent of all adults in the srteriosclerosis group were on a statin.
AHRQ-funded; HS022444.
Citation: Adedinsewo D, Taka N, Agasthi P .
Prevalence and factors associated with statin use among a nationally representative sample of US Adults: National Health and Nutrition Examination Survey, 2011-2012.
Clin Cardiol 2016 Sep;39(9):491-6. doi: 10.1002/clc.22577.
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Keywords: Cardiovascular Conditions, Diabetes, Medication, Disparities, Racial and Ethnic Minorities