Evaluating the Impact of Race-Specific Pooled Risk Equations for Cardiovascular Risk Prediction on Clinical Outcomes
Description: Cardiovascular disease (CVD) is the leading cause of death and disability affecting an estimated 85.6 million Americans and accounting for 1 in every 6 healthcare dollars spent (1). Racial and ethnic disparities in cardiovascular health remain pervasive in United States and require urgent attention (2). In clinical care, risk assessment is a critical step in primary prevention of atherosclerotic cardiovascular disease (ASCVD). The American College of Cardiology and the American Heart Association Task Force on Practice Guidelines published the ASCVD pooled cohort equation (PCE) (3). The PCE used data from community-based cohorts to broaden the ASCVD risk prediction to minorities (3). Statistical methods were used to provide race- and sex-specific estimates of the 10-year risk of ASCVD for Black and White women and men ages 40 to 79 years (3). The inclusion of race in the PCE, and other clinical algorithms, has been flagged as problematic and could be a potential contributor to the current disparities in healthcare (4). It is increasingly recognized that race is a social construct and not a biologic trait (4). The objective of this study is to investigate the effect of race-specific pooled risk equations on 10-year cardiovascular risk estimate. A previous preliminary study we conducted on a smaller cohort which included the residents of Olmsted County Minnesota revealed that use of race-specific models had minimal effect on the performance of ASCVD risk score. We wish to expand on this work by performing similar analysis using a larger cohort from 27 counties in Minnesota. Our study will have two aims. First, to compare race specific pooled-cohort equation by race, ethnicity, and sex. Second, to identify the extent of the misclassification of risk by race and sex. We plan to achieve our objectives by leveraging the Rochester Epidemiology Project (REP). The REP is a medical records-linkage system that includes electronic health records data from local health care providers for over a million persons who have lived in a 27-county Midwest region after January 1, 2010 (5). Despite the proportion of racial and ethnic minorities in the population being low, the absolute numbers are large enough for meaningful stratified analyses in all racial and ethnic minority populations. Finally, our study will achieve the goal of examining the utility of including race in the ASCVD and highlight the clinical implications (e.g. prescription of lipid lowering medications).
Funder: American Heart Association
Amount: $50,000
Funding type: research
Funder scheme: Assessing Race in Clinical Research Models
Start date: 2023-07-01
End date: 2024-06-30
Investigators: Ramla Kasozi, Ramla Kasozi
Institution: Mayo Clinic Jacksonville
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Funded outputs count: 0
Funder award ID: 23ARCRM1077170
OpenAlex ID: G4542021772