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Atherosclerotic Cardiovascular Disease Primary and Secondary Prevention in Latino Subgroups.
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- Author(s): Kaufmann, Jorge; Marino, Miguel; Lucas, Jennifer A.; Rodriguez, Carlos J.; Boston, Dave; Giebultowicz, Sophia; Heintzman, John
- Source:
JGIM: Journal of General Internal Medicine; Aug2024, Vol. 39 Issue 11, p2041-2050, 10p- Subject Terms:
- Source:
- Additional Information
- Abstract: Background: Studies assessing equity in the prevention of atherosclerotic cardiovascular disease (ASCVD) for Latinos living in the USA collectively yield mixed results. Latino persons are diverse in many ways that may influence cardiovascular health. The intersection of Latino nativity and ASCVD prevention is understudied. Objective: To determine whether disparities in ASCVD screening, detection, and prescribing differ for US Latinos by country of birth. Design: A retrospective cohort design utilizing 2014–2020 electronic health record data from a network of 320 community health centers across 12 states. Analyses occurred October 1, 2022, to September 30, 2023. Participants: Non-Hispanic White and Latino adults age 20–75 years, born in Cuba, Dominican Republic, El Salvador, Guatemala, Honduras, Mexico, and the USA. Exposures: Ethnicity and country of birth. Main Measures: Outcome measures included prevalence of statin eligibility, of having insufficient data to establish eligibility, odds of having a documented statin prescription, and rates of statin prescriptions and refills. We used covariate-adjusted logistic and generalized estimating equations logistic and negative binomial regressions to generate absolute and relative measures. Key Results: Among 108,672 adults, 23% (n = 25,422) were statin eligible for primary or secondary prevention of ASCVD using American College of Cardiology/American Heart Association guidelines. Latinos, born in and outside the USA were more likely eligible than Non-Hispanic White patients were (US-born Latino OR = 1.55 (95% CI = 1.37–1.75); non-US-born Latino OR = 1.63 (95% CI = 1.34–1.98)). The eligibility criteria that was met differed by ethnicity and nativity. Latinos overall were less likely missing data to establish eligibility and differences were again observed by specific non-US country of origin. Among those eligible, we observed no statistical difference in statin prescribing between US-born Latinos and non-Hispanic White persons; however, disparities varied by specific non-US country of origin. Conclusion: Efforts to improve Latino health in the USA will require approaches for preventing and reversing cardiovascular risk factors, and statin initiation that are Latino subgroup specific. [ABSTRACT FROM AUTHOR]
- Abstract: Copyright of JGIM: Journal of General Internal Medicine is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Abstract:
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