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Cardiovascular Care for Hispanic Americans

Cardiovascular Care for Hispanic Americans

According to current estimates, more than 53 million Hispanics live in the United States, constituting about 17% of the total U.S. population. Hispanic Americans are the fastest-growing racial or ethnic population in the country and are expected to make up about 30% of the total population by 2050. “Hispanics are a diverse ethnic population, varying in race, origin, immigration status, and other socioeconomic factors,” says Carlos J. Rodriguez, MD, MPH. “The diversity among U.S. Hispanics presents many challenges.” Dr. Rodriguez says that Hispanics are a segment of the population that has been somewhat ignored in clinical research relating to cardiovascular disease (CVD). “We’re lacking comprehensive research data on the prevalence of risk factors for CVD among Hispanics,” he says. Only recently have national surveys started including more in-depth information pertaining to Hispanic Americans. Greater efforts have been made to specifically address CVD risk among U.S. Hispanics of late. This research has indicated that there is a sizeable burden of CVD risk factors among these individuals. More studies are still needed because Hispanics are the largest ethnic minority in the U.S. and are likely to significantly impact future healthcare costs. A Comprehensive Review There currently is no comprehensive resource about the cultural values and behavioral aspects that influence the promotion, prevention, and acceptance of heart health and treatment recommendations for Hispanics. To address some of the gaps in knowledge about the burden of CVD among Hispanics, the American Heart Association (AHA) released a scientific advisory on the status of CVD and stroke in Hispanic and Latino Americans. Published in Circulation, the document provides for the first time a comprehensive overview...
Analyzing Statin Use

Analyzing Statin Use

Recently, the American College of Cardiology (ACC) and the American Heart Association (AHA) updated their cho­lesterol guidelines, which shifted away from a focus on treating to target LDL cholesterol levels and toward minimizing global cardiovascular risk. The updated ACC/AHA guidelines substantially broadened the number of people for whom statins are recommended, primarily by enlarging the eligible population to those with lower levels of cardiovascular risk. Examining Patterns Whereas previous studies have shown that statin use is increasing in the United States, others have shown that use of these medications is suboptimal, even among high-risk individuals. “We have few data that have looked at how cardiovascular risk and specific risk factors contribute to the actual prescribing of statins,” says Michael E. Johansen, MD, MS. In an effort to address this research gap, he and his colleagues conducted a study—published in Annals of Family Medicine—that looked at the relationships between statin use and cardiovascular risk as well as diagnosed hyperlipidemia and other specific risk factors using a nationally representative sample. The study by Dr. Johansen and colleagues analyzed data from the 2010 Medical Expenditure Panel Survey and involved more than 16,000 patients aged 30 to 79. Those who reported filling at least two statin prescriptions were classified as statin users. “Overall, only about 50% to 60% of people at high cardiovascular risk were prescribed statins,” says Dr. Johansen. The study revealed that slightly more than 58% of individuals with coronary artery disease (CAD) and 52% of those with diabetes older than 40 were statin users. After adjusting for cardio­vascular risk and sociodemographic factors, the probability of being on a statin was...
On the Unity of Doctors

On the Unity of Doctors

Doctors are facing challenges like never before. Not only are new medications being discovered and novel technologies being implemented, we are being bombarded with new regulations. Years ago, people were talking about how to improve the doctor-patient relationship. Currently, all the journals are talking about big data, EHR, meaningful use, and ICD-10. Not only do we need to stay current with all the medical innovation taking hold, we need to learn how to comply with all these regulations. Many doctors feel these requirements are actually not helpful as being touted. In fact, we feel there is harm being done because they are taking us away from direct contact with the patient. According to a study out of the American Journal of Emergency Medicine, it has been estimated that ER docs spend 44% of time on electronic data entry and 28% on patient contact. Doctors are becoming increasingly vocal on speaking up against these regulations that we are forced to comply with. However, after years of being forbidden to unionize or collectively bargain, we are often doing it alone. We feel isolated in this sea of chaos. Polices will never change based on just one voice. If we are to drive policy change and shape regulations to become meaningful for the quality of medicine, we need to find a unified voice. How can doctors find unity and speak up against wrongful healthcare policies? 1. We can share information about these policy changes. We all need to stay up-to-date with them for our own practices. When we are aware, share them and discuss with other doctors why or why not these...
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