New Knowledge and Strategies to Address Inequalities in Heart Disease in Special Issue of The American Journal of the Medical Sciences
There's a "critical need" for research and innovative new strategies to address health disparities and to improve health outcomes across all groups of people with cardiovascular disease, according to a special symposium feature in the August issue of The American Journal of Medical Sciences (AJMS), official journal of the Southern Society for Clinical Investigation (SSCI). The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.
The Symposium papers represent a step toward understanding differences in the risk factors, management, and outcomes of cardiovascular disease by race, age, and sex, according to an Introduction by Dr. Marie "Tonette" Krousel-Wood of Tulane University and colleagues. They write, "This knowledge can foster development of interventions tailored to individual needs and delivered at the right time" to achieve the best outcomes in all people.
New Data, New Ideas for Reducing Disparities in Heart Disease
According to Healthy People 2020, health disparities are differences in health that are linked to "social, economic, and/or environmental disadvantage." Health disparities negatively impact groups experiencing greater obstacles to health based on age, gender, race, or other factors. The Symposium presents ten new research and review papers providing a foundation for addressing disparities in cardiovascular disease in the US population and the factors contributing to them.
The Symposium leads off with two studies reporting that experiencing stressful circumstances is associated with cellular markers of stress and aging in children, and that having risk factors for heart disease in childhood is associated with negative health outcomes in adulthood. The findings from the first study also suggest that boys may be different from girls in terms of their biological response to experience with early-life stress. The second study suggests a trend with childhood obesity and greater negative health impact on blood vessel disease in both black and white girls compared to boys, while high cholesterol may have a larger negative effect in white boys compared to the other boys and girls. This line of research may help in developing "early race- and sex-specific interventions [in childhood] that may mitigate health disparities in adulthood."
Other Symposium topics and findings include:
- Gaps in treatment with cholesterol-lowering statin drugs—particularly among adults at high risk for future coronary heart disease (CHD) events. African Americans, women, and patients in the Southeastern United States are also less likely to take recommended statin treatment.
- New data on the rising rate of chronic kidney disease among the "oldest old"—people aged 80 years and older. The number of such patients is expected to triple or quadruple by 2050.
- A new approach to identifying "hidden motives and underlying assumptions" factors affecting the problem of non-adherence—patients not taking their prescribed medications—which may be useful in overcoming adherence challenges in women and other groups.
- New studies on disparities in the management of hypertension, calling attention to the lack of evidence behind blood pressure guidelines for older adults; factors contributing to the higher rate of hypertension, and cardiovascular disease risk, in African-Americans; and a promising intervention to improve blood pressure control in uninsured patients.
- Disparities in the use of cardiac rehabilitation in patients with CHD. Women and minority patients have lower referral rates, and are less likely to enroll in and complete cardiac rehab.
- Emerging evidence that the cumulative effects of "everyday sexism" might contribute to the disproportionate differences in negative cardiovascular health outcomes in women compared to men.
The articles in the special issue "[E]xplore differences in cardiovascular and related diseases and thus provide a foundation for addressing health disparities in these chronic conditions," Dr. Krousel-Wood and coauthors write. They hope the Symposium papers will contribute to understanding health differences, developing tailored approaches to disease management, and reducing health disparities across age, sex, and racial groups.
About The American Journal of the Medical Sciences
Founded in 1820, The American Journal of the Medical Sciences (AJMS) is the official journal of the Southern Society for Clinical Investigation. Regular features include Clinical and Basic Investigation studies, Reviews, Historical Articles, Case-letters, and Images in the Medical Sciences. Other special features include contributions from the University of Texas Southwestern Medical Center, Cardiology Grand Rounds from Vanderbilt University and Emory University, Case Records of the VA Maryland Healthcare System/University of Maryland Medicine, Clinical Reasoning: A Case-Based Series from Tulane University, Pathophysiology in Medicine as well as Trainee Research Reports. The AJMS publishes clinical and basic investigation articles dealing with topics such as infectious disease, rheumatology/immunology, hematology/oncology, cardiology, pulmonology/critical care, gastroenterology, nephrology, neurology and endocrinology.
About the Southern Society for Clinical Investigation
Founded in 1946, the Southern Society for Clinical Investigation (SSCI) is a regional academic society dedicated to the advancement of medically-related research. Its major focus is on encouraging students and postgraduate trainees (residents and fellows) to enter academic medicine and to support junior faculty success in clinical investigation. SSCI members are committed to mentoring future generations of medical investigators and promoting careers in academic medicine.
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