Balla Sujana, Gomez Sofia Elena, Rodriguez Fatima
Department of Medicine, University of California San Francisco-Fresno, 155 N Fresno St, Fresno, CA 93701 USA.
Division of Cardiovascular Medicine and the Cardiovascular Institute, Stanford University, 870 Quarry Road, Falk CVRC, Stanford, CA 94305-5406 USA.
Curr Treat Options Cardiovasc Med. 2020;22(12):75. doi: 10.1007/s11936-020-00869-z. Epub 2020 Nov 17.
Racial, ethnic, and gender disparities in cardiovascular care are well-documented. This review aims to highlight the disparities and impact on a group particularly vulnerable to disparities, women from racial/ethnic minority backgrounds.
Women from racial/ethnic minority backgrounds remain underrepresented in major cardiovascular trials, limiting the generalizability of cardiovascular research to this population. Certain cardiovascular risk factors are more prevalent in women from racial/ethnic minority backgrounds, including traditional risk factors such as hypertension, obesity, and diabetes. Female-specific risk factors including gestational diabetes and preeclampsia as well as non-traditional psychosocial risk factors like depressive and anxiety disorders, increased child care, and familial and home care responsibility have been shown to increase risk for cardiovascular disease events in women more so than in men, and disproportionately affect women from racial/ethnic minority backgrounds. Despite this, minimal interventions to address differential risk have been proposed. Furthermore, disparities in treatment and outcomes that disadvantage minority women persist. The limited improvement in outcomes over time, especially among non-Hispanic Black women, is an area that requires further research and active interventions.
Understanding the lack of representation in cardiovascular trials, differential cardiovascular risk, and disparities in treatment and outcomes among women from racial/ethnic minority backgrounds highlights opportunities for improving cardiovascular care among this particularly vulnerable population.
心血管护理中的种族、民族和性别差异已有充分记录。本综述旨在强调这些差异以及对一个特别容易出现差异的群体——来自种族/民族少数群体背景的女性——的影响。
来自种族/民族少数群体背景的女性在主要心血管试验中的代表性仍然不足，这限制了心血管研究结果对该人群的普遍适用性。某些心血管危险因素在来自种族/民族少数群体背景的女性中更为普遍，包括高血压、肥胖和糖尿病等传统危险因素。女性特有的危险因素，如妊娠期糖尿病和先兆子痫，以及非传统的心理社会危险因素，如抑郁和焦虑症、增加的儿童照料以及家庭和家庭护理责任，已被证明比男性更易增加女性心血管疾病事件的风险，并且对来自种族/民族少数群体背景的女性影响尤为严重。尽管如此，针对不同风险的干预措施却很少被提出。此外，使少数族裔女性处于不利地位的治疗和结果差异仍然存在。随着时间的推移，结果改善有限，尤其是在非西班牙裔黑人女性中，这是一个需要进一步研究和积极干预的领域。
了解来自种族/民族少数群体背景的女性在心血管试验中的代表性不足、心血管风险差异以及治疗和结果差异，凸显了改善这一特别弱势群体心血管护理的机会。
