Ethnic differences in the prevalence and treatment of cardiovascular risk factors in US outpatients with peripheral arterial disease: insights from the reduction of atherothrombosis for continued health (REACH) registry

Am Heart J. 2009 Dec;158(6):1038-45. doi: 10.1016/j.ahj.2009.09.014.

Abstract

Background: Prior investigations to define ethnic-related differences in the risks, medical treatment, and outcomes of patients with peripheral arterial disease (PAD) have been limited.

Methods: The impact of ethnicity on the risk factor profiles, use of evidence-based medical therapies, and 2-year cardiovascular outcomes were investigated in 2,168 individuals (blacks n = 237, Hispanics n = 115, whites n = 1,816) from the United States with PAD from the international Reduction of Atherothrombosis for Continued Health Registry.

Results: Blacks and Hispanics were more likely to have diabetes mellitus and hypertension, whereas whites had a higher rate of diagnosed hypercholesterolemia. Control of blood pressure and cholesterol levels differed significantly in the groups at baseline: elevated blood pressure was present in 55% of blacks versus 48% of Hispanics versus 38% of whites (P < .01), whereas 41% of blacks versus 31% of Hispanics versus 25% of whites had elevated total cholesterol (P < .01). Aspirin use (62% of blacks vs 68% of Hispanics vs 72% of whites, P < .01) and statin use (72% of blacks vs 68% of Hispanics vs 77% of whites, P = .03) also varied significantly. In this context, rates by ethnicity for cardiovascular death, myocardial infarction, or stroke seemed to be no different at 2 years, at 8.8% for the total population: 11.6% for blacks, 8.5% for whites, and 5.0% for Hispanics (P = .32). Fewer blacks (0.6%) had undergone peripheral arterial bypass surgery compared with whites (3.4%) and Hispanics (5.2%) (P = .02).

Conclusions: Ethnic-related differences have been documented in the prevalence and treatment of several atherosclerotic risk factors known to be associated with PAD, including a variation in the use of surgical revascularization procedures.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Black or African American*
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / therapy*
  • Female
  • Hispanic or Latino*
  • Humans
  • Male
  • Outpatients
  • Peripheral Vascular Diseases / complications
  • Peripheral Vascular Diseases / epidemiology*
  • Peripheral Vascular Diseases / therapy*
  • Prevalence
  • Registries
  • Risk Factors
  • United States
  • White People*