Cardiovascular Disease in Racial/Ethnic Minorities: Overview and Perspectives

Abstract

African-Americans have the highest rate of coronary disease mortality, premature death (including Sudden death), stroke (fatal and non-fatal), hypertension, type 2 diabetes, and obesity (especially black females) when compared to whites. Cardiovascular health, life-expectancy, and health care, while improving dramatically for all Americans over the last century, have not been distributed equitably. Racial/ethnic-based CVD research may offer the opportunity to clarify vital environmental and inherited aspects in the development of CVD, illustrate the importance of lifestyle, unmask variations in clinical practice, and potentially improve health-care delivery for all Americans. A review of the various chapters of this book is included, specifically highlighting important concepts related to the prevention of cardiovascular conditions in racial/ethnic minorities through the consideration of risk factors, treatment options, and clinical trials. To combat the distressingly high rates of hypertension morbidity and mortality in African Americans, the International Society on Hypertension in Blacks (ISHIB) promulgated guidelines suggesting combination therapy and more intensive therapy for most black patients. Similarly, the National Cholesterol Education Program Adult Treatment Panel III delineates special considerations in African Americans. Simply identifying racial/ethnic health disparities will not eliminate them. Health-care education in the future should recognize the essential nature of the patient's cultural identity and experiences and understanding social factors and support systems. Clinicians must integrate an understanding of culture, lifestyle, socioeconomic status, the impact of psychological stress, and bias within the health-care system to assist patients with achieving positive outcomes.