Racial and Ethnic Disparities in Primary Prevention of Cardiovascular Disease

Abstract

Cardiovascular disease (CVD) disproportionately affects ethnic minority groups globally. Ethnic minority groups face particularly high CVD burden and mortality, exacerbated by disparities across modifiable risk factors, wider determinants of health and limited access to preventative interventions. This narrative review summarises evidence on modifiable risk factors such as physical activity, hypertension, diet, smoking, alcohol, diabetes and the polypill for the primary prevention of CVD in ethnic minorities. Across these factors, we find inequities in risk factor prevalence. The evidence underscores that inequalities in accessibility to interventions and treatments impede progress in reducing CVD risk using primary prevention interventions for ethnic minority people. While culturally tailored interventions show promise, further research is required across the different risk factors. Social determinants of health and structural inequities also exacerbate ethnic minority people’s CVD risk and warrant greater attention. Additionally, we find there is limited ethnicity-specific data and guidelines on CVD primary prevention interventions for most risk factors. To address these gaps in research, we provide recommendations which include: investigating the sustainability and real-world effectiveness of culturally sensitive interventions, ensuring ethnic minority peoples’ perspectives in research are considered, longitudinal tracking of risk factors, interventions and outcomes in ethnic minority people and ensuring data collection and reporting of ethnicity data is standardised. Cardiovascular disease (CVD) disproportionately affects ethnic minority groups globally. Ethnic minority groups face particularly high CVD burden and mortality, exacerbated by disparities across modifiable risk factors, wider determinants of health and limited access to preventative interventions. This narrative review summarises evidence on modifiable risk factors such as physical activity, hypertension, diet, smoking, alcohol, diabetes and the polypill for the primary prevention of CVD in ethnic minorities. Across these factors, we find inequities in risk factor prevalence. The evidence underscores that inequalities in accessibility to interventions and treatments impede progress in reducing CVD risk using primary prevention interventions for ethnic minority people. While culturally tailored interventions show promise, further research is required across the different risk factors. Social determinants of health and structural inequities also exacerbate ethnic minority people’s CVD risk and warrant greater attention. Additionally, we find there is limited ethnicity-specific data and guidelines on CVD primary prevention interventions for most risk factors. To address these gaps in research, we provide recommendations which include: investigating the sustainability and real-world effectiveness of culturally sensitive interventions, ensuring ethnic minority peoples’ perspectives in research are considered, longitudinal tracking of risk factors, interventions and outcomes in ethnic minority people and ensuring data collection and reporting of ethnicity data is standardised.

Topics & Concepts