Division of Cardiovascular Medicine, Department of Internal Medicine Vanderbilt University Medical Center Nashville TN USA.
Division of Vascular Medicine, Department of Medicine UT Southwestern Medical Center Dallas TX USA.
J Am Heart Assoc. 2024 Nov 5;13(21):e031446. doi: 10.1161/JAHA.123.031446. Epub 2024 Nov 4.
Peripheral artery disease (PAD) is a progressive atherosclerotic disease that causes lower extremity arterial stenosis or occlusion. Patients with PAD are at increased risk of myocardial infarction, stroke, limitations in ambulation, and amputation. Despite the advances in medicine and technology, the outcomes from PAD, including critical limb-threatening ischemia, acute limb ischemia amputation, and mortality, remain increased among specific racial and ethnic groups that have been historically marginalized in America, including Black, Hispanic, and American Indian individuals in the United States when compared with White persons. The purpose of this review is to summarize PAD literature that incorporates racial and ethnic disparities in PAD. There are a rising number of studies focused on the interface of racial and ethnic disparities and PAD. The majority of these studies are specifically focused on Black race, whereas there are limited studies focused on other minoritized racial and ethnic groups in the United States. The application of race and ethnicity has also been shown to play a synergistic role with socioeconomic status on PAD outcomes. Effective strategies focused on implementing policies that support quality measures and focus on social determinants of health have been shown to promote health equity and reduce disparities. Current evidence suggests that biological differences are less likely to be the leading cause of disparities in PAD between racial and ethnic groups compared with White Americans and supports a renewed focus on social determinants of health to achieve health equity.
外周动脉疾病(PAD)是一种进行性动脉粥样硬化疾病,可导致下肢动脉狭窄或闭塞。PAD 患者发生心肌梗死、中风、活动受限和截肢的风险增加。尽管医学和技术取得了进步,但特定种族和族裔群体的 PAD 结局(包括严重肢体缺血、急性肢体缺血性截肢和死亡率)仍然较高,这些群体在美国历史上一直处于边缘化地位,包括美国的黑人、西班牙裔和美洲原住民,与白人相比。本综述的目的是总结纳入 PAD 种族和族裔差异的 PAD 文献。越来越多的研究侧重于种族和族裔差异与 PAD 的接口。这些研究大多数专门针对黑人种族,而针对美国其他少数族裔群体的研究则有限。种族和民族的应用也被证明与社会经济地位在 PAD 结局上具有协同作用。已证明,专注于实施支持质量措施和关注健康决定因素的政策的有效策略可促进健康公平并减少差异。现有证据表明,与美国白人相比,生物差异不太可能是导致 PAD 在不同种族和族裔之间出现差异的主要原因,并支持重新关注健康决定因素以实现健康公平。