Khedagi Apurva, Hoke Cara, Kelsey Michelle, Coviello Andrea, Jones W Schuyler, Jackson Larry R, Patel Manesh R, McGarrah Rob W, Pagidipati Neha J, Shah Nishant P
Department of Medicine, Duke University School of Medicine, Durham, NC.
Division of Cardiology, Duke University School of Medicine, Durham, NC.
Am J Prev Cardiol. 2023 Feb 24;13:100477. doi: 10.1016/j.ajpc.2023.100477. eCollection 2023 Mar.
Cardiovascular disease remains one of the most prominent global health problems and has been demonstrated to disproportionally affect certain communities. Despite an increasing collective effort to improve health inequalities, a multitude of disparities continue to affect cardiovascular outcomes. Among the most prominent disparities within cardiovascular disease prevention are with the use and distribution of sodium-glucose cotransporter-2 (SGLT-2) inhibitors and glucagon-like peptide 1 (GLP-1) receptor agonists. Several landmark trials have demonstrated the efficacy of these novel agents, not only in cardiovascular disease prevention among those with diabetes, but also in heart failure and chronic kidney disease. However, the use of these agents remains limited by disparities in certain racial/ethnic, sex, and socioeconomic groups. This review works to highlight and understand these differences on the use and prescribing patterns of pivotal agents in cardiovascular disease prevention, SGLT-2 inhibitors and GLP-1 agonists. Our aim is to enrich understanding and to inspire efforts to end disparities in cardiovascular morbidity and mortality due to race, sex and income inequality.
心血管疾病仍然是全球最突出的健康问题之一，并且已被证明对某些社区的影响尤为严重。尽管为改善健康不平等现象做出了越来越多的集体努力，但众多差异仍继续影响心血管疾病的治疗结果。在心血管疾病预防方面最突出的差异之一在于钠-葡萄糖协同转运蛋白2（SGLT-2）抑制剂和胰高血糖素样肽1（GLP-1）受体激动剂的使用和分配情况。多项具有里程碑意义的试验已证明这些新型药物的疗效，不仅在糖尿病患者的心血管疾病预防方面有效，而且在心力衰竭和慢性肾脏病方面也有效。然而，这些药物的使用在某些种族/族裔、性别和社会经济群体中仍因差异而受到限制。本综述旨在突出并理解这些差异对心血管疾病预防关键药物SGLT-2抑制剂和GLP-1激动剂的使用及处方模式的影响。我们的目标是加深理解，并激发努力消除因种族、性别和收入不平等导致的心血管疾病发病率和死亡率差异。
