As you may know, health equity was a major focus of the AHA 2021 Scientific Sessions, with numerous sessions that focused on cardiovascular health disparities, equity in treatment of cardiovascular disease and plenty of original health equity research. Here is a run-down of some great presentations about important topics in cardiovascular health equity from #AHA21, all of which are still available for viewing at your leisure ON DEMAND! [Please note that this list by no means comprehensive; there were many other amazing presentations which I did not have space to include here].
Fixing the Root Cause: Addressing Systemic Racism and Social Determinants of Health in Heart Failure [Oral Presentation]
This excellent and comprehensive presentation by Dr. Khadijah Breathett, MD, MS, FACC, FAHA, FHFSA showcases data from numerous studies that have found racial disparities in heart failure incidence or heart failure outcomes, vast racial disparities in access to advanced heart failure care (such as heart transplant or left ventricular assist devices), racial and gender bias in treatment of heart failure and strategies for advancing equity in treatment of heart failure. This presentation can be found in the Embracing the Melting Pot to Reduce Heart Failure: Genetics and Social Determinants of Health Session.
Association Between Community-Level Violent Crime and Cardiovascular Mortality in Chicago – A Longitudinal Analysis [Oral Presentation]
This study, conducted by Eberly et al, utilized data from the Illinois Department of Public Health and Chicago Police Department to examine the association between longitudinal changes over three time periods from 2000 to 2014 in violent crime and cardiovascular mortality rates (such as total cardiovascular mortality or coronary artery disease mortality) at the community level in Chicago, IL. They found that decrease in a community’s violent crime rates was significantly associated with a decrease in cardiovascular and coronary artery disease mortality rates. This study was presented in the Social Determinants of Cardiovascular Health Session.
Race, eGFR, and Cardiovascular Risk: A Tale of Modern Structural Racism [Oral Presentation]
This wonderful talk by Dr. Nwamaka Eneanya, MD, MPH, FASN provides a comprehensive overview of an incredibly timely and important topic. In this presentation, Dr. Eneanya establishes a clear throughline between structural racism, utilization of race in calculation of eGFR, resulting racial disparities in access to chronic kidney disease-related care (e.g. dialysis or kidney transplantation) and racial disparities in CKD-related outcomes, as well as recommendations for future non-race based approaches to define and manage chronic kidney disease. This presentation can be found in the Race, Bias and Barriers in the Cardiovascular Care of Patients with CKD Session.
Racial and Gender Differences in Lifetime Healthcare Costs Across Cardiovascular Risk Factors [Oral Presentation]
This study, conducted by Khera et al, utilized data from the Dallas Heart Study and the Dallas-Fort Worth Hospital Council Database from 2000 to 2018 to examine the relationship between factors such as race or sex and cumulative lifetime health care expenses. They found that lifetime health care expenses were substantially higher in Black individuals and men, and increased substantially with increases in cardiovascular risk factors, with many of these differences emerging after age 60. This study was presented in the Addressing Critical Questions of Health Equity and CVD Session.
Association of Cumulative Social Risk Score With Cardiovascular Outcomes in the Multi-Ethnic Study of Atherosclerosis (MESA) [Oral Presentation]
This study, conducted by Hammoud et al, utilized data from the prospective Multi-Ethnic Study of Atherosclerosis (MESA) cohort to assign a social disadvantage score (SDS) to MESA Participants based on income level, education level, single-living status and perception of lifetime discrimination (e.g. mistreated by neighbors, mistreated by police, etc.). They examined association between SDS and atherosclerotic cardiovascular disease (ASCVD) and all-cause mortality; they found that as social disadvantage score increased, so too did incidence of ASCVD and all-cause mortality. This research was presented in the Social Determinants of Cardiovascular Health Session.
Neighborhood Social Vulnerability is Associated With Major Adverse Cardiovascular Events and Deaths Among Patients Hospitalized with COVID-19: An Analysis of the AHA COVID-19 Cardiovascular Disease Registry [Poster presentation]
This study, conducted by Islam et al, utilized data from the American Heart Association COVID-19 Cardiovascular Health Registry to examine the association between neighborhood social vulnerability and major adverse cardiovascular events for patients hospitalized with COVID-19. They found that patients who resided in more socially vulnerable neighborhoods and were hospitalized with COVID-19 were more likely to experience adverse cardiovascular events during their hospitalization.
Income and Antiplatelet Adherence Following Acute Coronary Syndrome: An Administrative Claims Analysis [Oral Presentation]
This study, conducted by LaRosa et al, utilized data from a large and diverse health claims database to examine the association between household income status and antiplatelet adherence. They found that lower income status was associated with a greater likelihood of non-adherence with antiplatelet therapy after primary coronary intervention for acute coronary syndrome. This study was presented in the Social Determinants of Cardiovascular Health Session.
The Association of Social Risk Factors with Hypertrophic Cardiomyopathy Procedures and Mortality: US Nationwide Inpatient Sample, 2012-2018
This study, conducted by Johnson et al, utilized data form the U.S. Nationwide Inpatient Sample to examine the association between social risk factors, septal reduction therapy (e.g. septal myomectomy and alcohol septal ablation), ICD implantation and in-hospital mortality for patients with hypertrophic cardiomyopathy (HCM). They found significant heterogeneity in these outcomes by patient race, sex, income status and rurality.
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Andi Shahu is a resident physician in the Osler Medical Residency in Internal Medicine at Johns Hopkins Hospital in Baltimore, and will begin General Cardiology fellowship at Yale-New Haven Hospital in July 2021. He is interested in the intersection between cardiovascular outcomes, health equity and health policy. He is a member of the Council On Quality of Care and Outcomes Research (QCOR). He also loves traveling, writing, music and running. You can follow him on Twitter @andishahu.