Minority Health and Health Equity Archive
Permanent URI for this collectionhttp://hdl.handle.net/1903/21769
Welcome to the Minority Health and Health Equity Archive (MHHEA), an electronic archive for digital resource materials in the fields of minority health and health disparities research and policy. It is offered as a no-charge resource to the public, academic scholars and health science researchers interested in the elimination of racial and ethnic health disparities.
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Item Eliminating Disparities in Hypertension Care for Hispanics and Blacks Using a Heart Failure Disease Management Program(2011) Hebert, Kathy; Julian, Elyse; Alvarez, Jorge; Dias, Andre; Tamariz, Leonardo; Arcement, Lee; Quevedo, Henry C.Objectives: This study assessed if patients enrolled in a heart failure disease management program (HFDMP) reach the JNC VII target goals for blood pressure (BP) control, eliminate disparities in hypertension control by race/ethnicity and the impact BP control has on survival. Methods: Patients (N = 898) with an ejection fraction <40% were enrolled into two HFDMPs and screened for hypertension, defined as BP > 130/80. Results: Mean baseline systolic BP (SBP) 132 +/- 25.5 mm Hg and diastolic BP (DBP) 79 +/- 16.8 mm Hg. Final mean SBP decreased to 129.6 mm Hg, DBP 77.6 mm Hg. Whites had the highest rate of achieving BP goals. Mortality reduction was associated with minority race, history of hypertension, increase ejection fraction and statin use. Conclusion: HFDMPs are an effective way to reduce BP in hypertensive patients. Disparities by race and ethnicity were not seen after adjustment for disease modifiers. There was no mortality difference in those who reached BP goal.Item Association of Parental Heart Failure with Risk of Heart Failure in Offspring(2006) Lee, Douglas S.; Pencina, Michael J.; Benjamin, Emelia J.; Wang, Thomas J.; Levy, Daniel; O’Donnell, Christopher J.; Nam, Byung-Ho; Larson, Martin G.; D’Agostino, Ralph B.; Vasan, Ramachandran S.Background The association between heart failure in parents and the prevalence of left ventricular systolic dysfunction and the risk of heart failure in their offspring has not been investigated in a community-based setting. Methods We examined the cross-sectional association of heart failure in parents with the prevalence of left ventricular systolic dysfunction, as well as left ventricular mass, internal dimensions, and wall thickness, in 1497 participants of the Framingham Offspring Study (mean age, 57 years; 819 women) who underwent routine echocardiography. We also investigated prospectively whether heart failure in parents increased the risk of heart failure in 2214 offspring (mean age, 44 years; 1150 women). Results As compared with the 1039 participants whose parents did not have heart failure, the 458 participants in the cross-sectional cohort who had at least one parent with heart failure were more likely to have increased left ventricular mass (17.0 percent vs. 26.9 percent), left ventricular internal dimensions (18.6 percent vs. 23.4 percent), and left ventricular systolic dysfunction (3.1 percent vs. 5.7 percent); the multivariable- adjusted odds ratios were 1.35 (95 percent confidence interval, 0.99 to 1.84), 1.29 (95 percent confidence interval, 0.96 to 1.72), and 2.37 (95 percent confidence interval, 1.22 to 4.61), respectively. In the longitudinal cohort, heart failure developed in 90 offspring during follow-up (mean length of follow-up, 20 years). The age- and sex adjusted 10-year incidence rates of heart failure were 2.72 percent among offspring with a parent with heart failure, as compared with 1.62 percent among those without a parent with heart failure. This increase in risk persisted after multivariable adjustment (hazard ratio, 1.70; 95 percent confidence interval, 1.11 to 2.60). Conclusions Heart failure in parents is associated with an increased prevalence of left ventricular systolic dysfunction cross-sectionally and an elevated risk of heart failure longitudinally. Our data emphasize the contribution of familial factors to the heart failure burden in the community.Item BiDil: Race Medicine Or Race Marketing?(2005) Sankar, Pamela; Kahn, JonathanRecent Food and Drug Administration (FDA) approval of the first drug with a race-specific indication has fueled the controversy over the meaning of race and ethnicity and raised questions over whether this move should be seen as an advance or a setback in the struggle to address disparities in health status associated with race. The drug, BiDil, combines two generics long recognized as benefiting patients with heart failure, irrespective of race or ethnicity. The push to bring these drugs to market as a race-specific treatment was motivated by the peculiarities of U.S. patent law and a willingness to exploit race to gain commercial and regulatory advantage.Item Foundation Confronts the Disparities in Both the Disease Burden and Death Rates for African Americans Suffering From Heart Failure; Landmark Trial Signals Improved Quality of Care for African Americans with Heart Failure(2004) PR, NewswireBetween the ages of 45 and 64, African American males have a 70% higher risk for heart failure than Caucasian males. African American females between the ages of 45 and 54 have a 50% greater risk of developing heart failure than Caucasian females. The earlier onset of disease means higher rates of hospitalization, earlier disability, and higher rates of premature death (death before the age of 65)(1). This dramatic difference in health status and health outcomes can be attributed to a variety of factors, including lack of access to quality medical care. The National Minority Health Month Foundation (the Foundation) is pleased to recognize the potential advancements in treatment for heart failure in African Americans represented by the recently completed African American Heart Failure Trial (A- HeFT).