Interventions to Reduce Ethnic and Racial Disparities in Dyslipidemia Management

Abstract

Race and ethnicity are associated with disparities in risk assessment, screening, patient awareness, treatment, and control of dyslipidemia and can contribute to worsened cardiovascular outcomes. This review summarizes these gaps in care and highlights recent interventions aimed at reducing them. Disparities in dyslipidemia diagnosis and treatment are well documented among certain racial and ethnic minority groups. Less is known about dyslipidemia among Hispanics, Asians, and Native Americans/Pacific Islanders, who have significant heterogeneity in cardiovascular risk and outcomes. Programs to reduce inequalities have focused on targeted risk assessment, improved screening practices, statin adherence-enhancing policies, culturally inclusive risk factor modification campaigns, and multidisciplinary treatment teams, with variable success. Interventions to reduce racial/ethnic disparities in dyslipidemia are important at all phases of care. Nevertheless, initiatives concentrating on single elements of the lipid treatment cascade were generally less effective at improving clinical endpoints than those that comprehensively addressed multiple phases. Moreover, there was a disproportionately greater number of published studies analyzing patient-facing lifestyle-based risk factor modifications than other types of interventions. Future investigations should focus on understudied populations such as disaggregated Hispanic, Asian, and Native American populations. Additionally, innovative strategies utilizing information technology and provider-facing programs are needed.