Greater representation of racial and ethnic subgroups in population data and clinical trials, as well as "improved culturally congruent and competent communication about risk factors and symptoms," are needed when it comes to reducing disparities in the management and treatment of coronary artery disease (CAD) and stroke, according to a review authored by Michelle A. Albert, MD, MPH, FACC, et al., as part of a nine-part Focused Seminar series on racism and health equity published in the Journal of the American College of Cardiology.

As part of the review, Albert and colleagues highlight known differences across racial/ethnic populations in traditional cardiovascular risk factors like hypertension and diabetes, as well as call attention to the impacts of social determinants of health and structural racism within and outside of health care systems. However, they stress that underrepresentation of racial and ethnic minority patients and primary principal investigators in clinical trials make it difficult to have a complete and comprehensive understanding of health care disparities when it comes to CAD and stroke.

The review offers a series of potential strategies to improve health equity, including implementation of implicit bias training and provider culturally competent and congruent engagement and training; equitable health insurance coverage; use of equitable clinical financial algorithm modeling that prioritizes social determinants of health; standardization of clinical care protocols that address equity concerns; increasing the percentage of main principal investigators from racial/ethnic minority groups as well as patient diversity in clinical trials; and collaborative community-centric implementation research.

"Identification of strategic opportunities to address the social and structural factors responsible for racial and ethnic disparities is imperative to achieving equitable outcomes for patients with CAD and stroke," conclude Albert, et al.

Clinical Topics: Arrhythmias and Clinical EP, Cardiovascular Care Team, COVID-19 Hub, Heart Failure and Cardiomyopathies, Noninvasive Imaging, Prevention, Valvular Heart Disease, Atherosclerotic Disease (CAD/PAD), Implantable Devices, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias, Acute Heart Failure, Echocardiography/Ultrasound, Hypertension, Sleep Apnea

Keywords: Cardiology, Prejudice, Racism, Selection Bias, African Americans, Algorithms, Asian Americans, Atrial Fibrillation, Bariatric Surgery, Cardiomyopathy, Dilated, Benchmarking, Cardiomyopathy, Hypertrophic, Cardiopulmonary Resuscitation, Cardiovascular Diseases, Community Health Services, Coronary Artery Disease, COVID-19, Cultural Competency, Death, Sudden, Cardiac, Defibrillators, Implantable, Diabetes Mellitus, Type 2, Dementia, Echocardiography, Economic Status, Sexual and Gender Minorities, Ethnic Groups, Evidence-Based Medicine, Food Insecurity, Glycated Hemoglobin A, Health Care Costs, Health Equity, Health Personnel, Healthcare Disparities, Heart Disease Risk Factors, Heart Valve Diseases, Hospitals, Hispanic Americans, Heart Failure, Housing, Hypertension, Implementation Science, Insurance, Insurance Coverage, Minority Groups, Motivation, Morbidity, Obesity, Organizational Objectives, Outcome Assessment, Health Care, Out-of-Hospital Cardiac Arrest, Patient Discharge, Patient-Centered Care, Peripheral Arterial Disease, Prescriptions, Policy, Prevalence, Public Health, Quality Improvement, Reference Standards, Registries, Religion, Renal Insufficiency, Chronic, Reward, Risk Factors, Social Determinants of Health, Social Justice, Social Responsibility, Stroke, Survival Rate, Telemedicine, Telemedicine, Treatment Outcome, Trust, Violence, Violence, Workforce

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