Researchers at the Barbra Streisand Women’s Heart Center at the Smit Heart Institute at Cedars-Sinai find that racial and ethnic disparities influence long-term outcomes in a population of women with obstructive coronary artery disease treated at an academic medical center. I discovered that it does not give The results of this study were recently published in the Canadian Journal of Cardiology.
This retrospective study was conducted as part of the Women’s Ischemia Syndrome Evaluation (WISE), a multiyear, multicenter research project sponsored by the National Heart, Lung, and Blood Institute that studies the detection and evaluation of cardiovascular disease in women. Ta.
Janet Wei, M.D., senior corresponding author of the study and assistant professor of cardiology at the Smit Heart Institute, said a possible explanation for the study’s findings is based on evidence-based guidelines provided at academic medical centers. He said that cardiovascular care based on health outcomes could help ensure equal health outcomes. Opportunities for Black women, who are at higher risk of dying from cardiovascular disease compared to non-Black women.
“Our findings show that when women with coronary artery disease, like the women who participated in the WISE study, are treated in an academic setting, they experience less racial and ethnic discrimination, which is less likely than the guidelines This suggests that they may be able to receive appropriate treatment based on their medical conditions,” Wei said. He is Associate Medical Director of the Biomedical Imaging Institute and Co-Director of the Stress Echocardiography Laboratory at the Smit Heart Institute.
Although heart disease is the leading cause of death for women in most racial and ethnic groups in the United States, previous research has found significant differences in heart disease outcomes between black and non-black women. This includes earlier onset of cardiovascular disease and an incidence in nearly 20% of women. High cardiovascular-related mortality.
However, the reasons for these differences are unclear, leading Wei and other researchers to investigate factors associated with long-term adverse outcomes in black women with obstructive coronary artery disease.
Using data from the original WISE cohort of 944 women, researchers studied middle-aged women (one third of the cohort) who underwent coronary angiography revealing obstructive coronary artery disease. did. The women were followed for more than 10 years to monitor for heart attacks, strokes, hospitalizations for chest pain or heart failure, or any cause of death.
Compared to non-black women in the group, black women had higher rates of cardiovascular risk factors, including obesity (mean BMI of 31 for black women vs. 28 for non-black women) and high blood pressure (90% vs. 64). %); education level (50% vs. 19%) and income (62% of black women had an annual income of less than $20,000 vs. 32% of non-black women); and were more likely to have public health insurance (51% vs. 39% had Medicare, 21% vs. 6% had other public insurance, and 23% vs. 49% had private insurance. ).
However, black women used the same or more guideline-based treatments for coronary artery disease, such as cholesterol drugs and blood pressure-lowering drugs, compared with non-black women. And their long-term cardiovascular disease outcomes (including cardiovascular mortality) were similar to non-Black women with obstructive coronary artery disease (28% mortality for Black women; 28% mortality for non-Black women; rate is 20%).
Recent research has linked social determinants of health and structural racism to disparities in cardiovascular health. However, if racial disparities in cardiovascular treatment are reduced, racial disparities in cardiovascular disease outcomes may be reduced or even eliminated. ”
Janet Way, MD, Assistant Professor of Cardiology, Smit Heart Institute
In another recent study, Cedars-Sinai researchers found that black women with signs and symptoms of ischemia without obstructive coronary artery disease (INOCA) have an increased long-term risk of heart attack, stroke, or death. I discovered that.
Additionally, women with INOCA reported that they were less likely to be prescribed heart medications than women with obstructive coronary artery disease. Part of the reason is that traditional cardiology training encourages doctors to look for blockages in the coronary arteries when diagnosing coronary artery disease, making INOCA an often overlooked heart condition.
“Increasing understanding and awareness of how heart disease affects women is critical,” said Dr. WISE, principal investigator of the WISE clinical trial and director of the Barbra Streisand Women’s Heart Center. said C. Noel Bailey Mertz, M.D., director of the Linda Joy Paulin Women’s Heart Center. health program, the Irwin and Sheila Allen Chair in Women’s Heart Research at the Smit Heart Institute. “It is also important that appropriate guideline-based care is needed for all women, regardless of where they receive treatment.”
Bailey Mertz, Wei and other researchers from the WISE Study on More Equal Outcomes for Black Women aim to ground care in evidence-based guidelines to alleviate structural racism. We recommended that educational campaigns for doctors and local communities be used in local medical settings.
