Abstract
BackgroundCohort studies are recommended for understanding ethnic disparities in cardiovascular disease. Our objective was to review the process for identifying, including, and excluding ethnic minority populations in published cardiovascular cohort studies in Europe and North America.Methods and FindingsWe found the literature using Medline (1966–2005), Embase (1980–2001), Cinahl, Web of Science, and citations from references; consultations with colleagues; Internet searches; and RB's personal files. A total of 72 studies were included, 39 starting after 1975. Decision-making on inclusion and exclusion of racial/ethnic groups, the conceptual basis of race/ethnicity, and methods of classification of racial/ethnic groups were rarely explicit. Few publications provided details on the racial/ethnic composition of the study setting or sample, and 39 gave no description. Several studies were located in small towns or in occupational settings, where ethnic minority populations are underrepresented. Studies on general populations usually had too few participants for analysis by race/ethnicity. Eight studies were explicitly on Caucasians/whites, and two excluded ethnic minority groups from the whole or part of the study on the basis of language or birthplace criteria. Ten studies were designed to compare white and nonwhite populations, while five studies focused on one nonwhite racial/ethnic group; all 15 of these were performed in the US.ConclusionsThere is a shortage of information from cardiovascular cohort studies on racial/ethnic minority populations, although this has recently changed in the US. There is, particularly in Europe, an inequity resulting from a lack of research data in nonwhite populations. Urgent action is now required in Europe to address this disparity.
Highlights
IntroductionResearch on ethnic group differences and similarities may potentially help advance understanding of the relationships between risk factors and cardiovascular disease
Cardiovascular disease is the most common cause of death in most industrialised societies and is either the leading or a dominant cause of death for all racial and ethnic groups in the US and the UK
There is a shortage of information from cardiovascular cohort studies on racial/ethnic minority populations, this has recently changed in the US
Summary
Research on ethnic group differences and similarities may potentially help advance understanding of the relationships between risk factors and cardiovascular disease. Cardiovascular cohort studies have been one of the key approaches for achieving such understanding [2,3] Most such studies started after World War II, when coronary heart disease mortality increased in many western countries [2]. Ethnic minorities differ in their socio-economic circumstances, culture, lifestyle, and genetic make-up from the majority population (and there are, differences within the majority group and within minority groups) These differences in risk factors (such as diet and smoking) can influence a person’s susceptibility to disease. Researchers wanted to find out whether these cohort studies included or excluded ethnic minority groups
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