White Individuals Research Articles

Racial and Ethnic Disparities in Cardiotoxicity in Patients With Cancer Treated With Anthracyclines.

Cardiotoxicity in patients with cancer treated with anthracyclines is associated with increased morbidity and mortality. We aimed to examine the incidence of and risk factors for cardiotoxicity in a racially and ethnically diverse cohort with cancer treated with anthracyclines. We included consecutive adult patients who underwent anthracycline-based chemotherapy from 2016 to 2019 for any type of cancer. The end point was the development of cardiotoxicity (defined as clinical heart failure or drop in left ventricular ejection fraction ≥10% to ≤50%). A total of 743 individuals were included (28.0% Non-Hispanic [NH] White, 30.5% NH Black, 38.5% Hispanic, 3.0% Asian). Hypertension, diabetes, hyperlipidemia, obesity, and low socioeconomic status were more common in NH Black and Hispanic individuals. During a median follow-up of 21 months, 98 individuals (13.2%) developed cardiotoxicity. The incidence of cardiotoxicity was significantly higher in NH Black (16.3%), Hispanic (14.7%) and Asian (18.2%) individuals than in NH White (7.2%) individuals (P=0.024). After adjusting for cardiovascular risk factors, socioeconomic status score, anthracycline dose, baseline left ventricular ejection fraction, and cancer type, being NH Black (hazard ratio [HR], 2.62 [95% CI, 1.23-5.56]) or Hispanic (HR, 2.37 [95% CI, 1.11-5.07]) was independently associated with a higher risk of cardiotoxicity. NH Black and Hispanic individuals had a greater decline in left ventricular ejection fraction compared with NH White and Asian counterparts. The associations between baseline characteristics and incident cardiotoxicity were similar across different racial and ethnic groups. In a large retrospective multiracial and ethnic cohort treated with anthracyclines, NH Black, Hispanic, and Asian individuals had an increased risk of cardiotoxicity compared with their NH White counterparts.

Disparities in Antidiabetic Medication Discontinuation Between Non-Hispanic White and Black Beneficiaries in Medicare Across Diabetes Belt and Surrounding Area.

To assess racial and geographic disparities in antidiabetic medication discontinuation among Medicare beneficiaries with type 2 diabetes (T2D) in or around Diabetes Belt (DB) areas, with a specific focus on differences between non-Hispanic (NH) white and NH Black individuals. A retrospective cohort analysis was conducted on Medicare beneficiaries who initiated metformin and used antidiabetic medications during 2011-2015, including metformin, sulfonylureas, insulin, DPP-4 inhibitors, GLP-1 receptor agonists, SGLT2 inhibitors, and thiazolidinediones. Medication discontinuation was defined as a gap of 90days or more without any antidiabetic medications. Multivariable Cox regression was used to examine the influence of racial and geographic factors on medication discontinuation, controlling for demographic, socioeconomic, and contextual factors. The interaction between race and DB status was also examined. Among 21,159 Medicare beneficiaries initiating metformin during the study period, 8710 (41.2%) experienced medication discontinuation. NH Black individuals had a significantly higher discontinuation risk (HR: 1.22, 95% CI: [1.162, 1.286]) compared to NH White individuals. No significant geographic difference (HR: 1.02, 95% CI: [0.973, 1.072]) was observed between DB and Non-Diabetes Belt (NDB). NH Black patients consistently showed significantly higher discontinuation risks within both DB and NDB. No significant difference was found within the same race across counties. We found significant racial but no geographic disparities in antidiabetic medication discontinuation among Medicare beneficiaries with T2D. Further research is needed to understand the underlying factors to improve equitable diabetes care management.

Genetic Susceptibility to Type 2 Diabetes, Television Viewing, and Atherosclerotic Cardiovascular Disease Risk.

Type 2 diabetes (T2D) is a major risk factor for atherosclerotic cardiovascular disease (ASCVD). This study examined the interplay between watching television and T2D genetic risk for risk of ASCVD. We included 346 916 White British individuals from UK Biobank. A weighted polygenic risk score for T2D was calculated on the basis of 138 genetic variants associated with T2D. Time spent watching television was self-reported and categorized into 2 groups: ≤1 h/d and ≥2 h/d. Over a median 13.8-year follow-up, 21 265 incident ASCVD events were identified. Models using Cox regression with age as the underlying time scale adjusted for potential confounders (demographic, anthropometric, lifestyle factors, and medication use) were fit. Compared with watching television for ≤1 h/d, watching ≥2 h/d was associated with 12% (95% CI, 1.07-1.16) higher hazards of ASCVD, independently of T2D genetic risk. Joint analyses (with low T2D genetic risk and ≤1 h/d of television viewing as reference) indicated that medium and high T2D genetic risk was not associated with higher hazards of ASCVD as long as television viewing was ≤1 h/d. The P values for multiplicative and additive interactions between T2D genetic risk and television viewing were 0.050 and 0.038, respectively. The 10-year absolute risk of ASCVD was lower for high T2D genetic risk combined with ≤1 h/d of television viewing (2.13%) than for low T2D genetic risk combined with ≥2 h/d of television viewing (2.46%). Future clinical trials of lifestyle-modification interventions targeting specific types of screen-based sedentary activities could be implemented to individuals at high genetic risk of T2D for primary prevention of ASCVD.

Genomic Characterization of High-Grade Serous Ovarian Carcinoma Reveals Distinct Somatic Features in Black Individuals

Abstract Black individuals experience worse survival after a diagnosis of high-grade serous ovarian carcinoma (HGSC) than White individuals and are underrepresented in ovarian cancer research. To date, the understanding of the molecular and genomic heterogeneity of HGSC is based primarily on the evaluation of tumors from White individuals. In the present study, we performed whole exome sequencing on HGSC samples from 211 Black patients to identify significantly mutated genes and characterize mutational signatures, assessing their distributions by gene expression subtypes. The occurrence and frequency of somatic mutations and signatures by self-reported race were compared to historical data from The Cancer Genome Atlas (TCGA). Despite technical differences (e.g., formalin-fixed vs. fresh-frozen tissue), the distribution of mutations and their variant classifications for major HGSC genes were nearly identical across study populations. However, de novo significantly mutated gene analysis identified genes not previously reported in the TCGA analysis, including the oncogene KRAS and the potential tumor suppressor OBSCN. The prevalence of the homologous recombination deficiency signature was higher among Black individuals with the immunoreactive gene expression subtype compared with the mesenchymal and proliferative subtypes. These findings were confirmed by comparing the data from Black patients to 123 White patients with identical tissue collection and processing. Overall, this study suggests that, while most features of HGSC tumor phenotypes are similar in Black and White populations, there may be clinically-relevant differences. If validated, these phenotypes may be important for clinical decision-making and would have been missed by characterizing tumors from White individuals only.

Polygenic risk scores for incident dementia in the Multi-Ethnic Study of Atherosclerosis.

Over 75 Alzheimer's disease (AD) and dementia-associated variants have been identified through genome-wide association studies, but the utility of polygenic risk scores (PRS) for predicting AD and dementia in diverse and admixed populations remains unclear. We compared how PRS approaches differing in p -value thresholds, variant weights, and source ancestry perform in predicting dementia in 6,338 African American, Chinese, Hispanic, and White individuals from the Multi-Ethnic Study of Atherosclerosis. We tested clumping and thresholding (C+T) methods with varying parameters against Bayesian approaches (PRS-CS, PRS-CSx). We compared the ability of each method to predict incident dementia in all participants and in groups stratified by self-reported race/ethnicity. We additionally analyzed performance across groups stratified by estimated proportion of non-Finnish European (NFE)-like ancestry. Including more variants does not improve performance. The PRS based on C+T method with only 15 SNPs is more strongly associated with dementia (HR 5e-08 = 1.21, 95% CI: 1.11-1.31) than PRS derived from Bayesian models that include >800,000 SNPs (HR CSx = 1.13, 95% CI: 1.04-1.23), even in populations genetically dissimilar from the source data (HR lowNFE _ 5e-08 = 1.26, 95% CI: 1.08-1.47; HR lowNFE _ CSx = 1.13, 95% CI: 0.96-1.32). More selective PRS models using fewer SNPs may offer better AD prediction across diverse populations.

The Impact of Age on Outcomes in Seizure Hospitalizations—Analysis of a National Sample

The Impact of Age on Outcomes in Seizure Hospitalizations—Analysis of a National Sample

Differences in inflammation among black and white individuals: A systematic review and meta-analysis.

Differences in inflammation among black and white individuals: A systematic review and meta-analysis.

Comparative Efficacy of Glucagon-Like Peptide 1 Receptor Agonists for Cardiovascular Outcomes in Asian Versus White Populations: Systematic Review and Meta-analysis of Randomized Trials of Populations With or Without Type 2 Diabetes and/or Overweight or Obesity.

Cardiovascular outcome trials (CVOTs) suggest glucagon-like peptide 1 receptor agonists (GLP-1RAs) provide greater cardiovascular (CV) benefits in Asian compared with White individuals. Compare CV efficacy of GLP-1RAs between Asian and White individuals. Systematic review of PubMed and ClinicalTrials.gov (1 January 2015 to 1 November 2024). Randomized placebo-controlled CVOTs of GLP-1RAs. Risk of bias was assessed (RoB 2). Ethnicity-specific hazard ratios (HRs) for major adverse cardiovascular events (MACE). Random-effects meta-analyses per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines included eight trials (5,909 Asian individuals, 55,855 White individuals). GLP-1RA-associated MACE HR was 0.69 (95% CI 0.58, 0.83) in Asian people and 0.85 (95% CI 0.79, 0.91) in White people (Pinteraction = 0.045). Absolute MACE risk reduction was 2.9% (95% CI 1.5, 4.2) in Asian people versus 1.4% (0.9, 1.9) in White people. Lack of individual patient-level data precluded detailed subclassification of the Asian group. GLP-1RAs may offer greater MACE reductions in Asian compared with White individuals.

Disparities in prenatal care utilization among racial/ethnic and nativity subgroups in the United States.

Disparities in prenatal care utilization among racial/ethnic and nativity subgroups in the United States.

Socioeconomic and Demographic Disparities in Keratoconus Treatment

Socioeconomic and Demographic Disparities in Keratoconus Treatment

The first five years of implementing Missouri's medication first approach to opioid use disorder treatment: Plateaus, regressions, and underbellies of progress.

The first five years of implementing Missouri's medication first approach to opioid use disorder treatment: Plateaus, regressions, and underbellies of progress.

Next-generation sequencing demonstrates racial and sex differences in genomic profiling of hepatocellular carcinoma patients: an AACR GENIE project analysis.

Next-generation sequencing demonstrates racial and sex differences in genomic profiling of hepatocellular carcinoma patients: an AACR GENIE project analysis.

The Affordable Care Act and change in human papillomavirus (HPV) vaccine uptake in the United States.

The Affordable Care Act and change in human papillomavirus (HPV) vaccine uptake in the United States.

Unmasking Arrhythmia Mortality: A 25-Year Analysis of Trends and Disparities in the United States (1999-2023).

Arrhythmias are a significant cause of cardiovascular mortality in the U.S. This study examines trends in arrhythmia-related mortality from 1999 to 2023, focusing on gender, racial, regional disparities, and specific arrhythmic conditions. To analyze trends and disparities in arrhythmia-related mortality among U.S. adults aged ≥ 35 years from 1999 to 2023, with a focus on the impact of sex, race, geographic location, and urbanization. We analyzed mortality data from the CDC WONDER database, focusing on deaths where arrhythmias were a contributing cause. Age-adjusted mortality rates (AAMRs) were calculated and stratified by sex, race/ethnicity, state, and region. The annual percentage change (APC) and average annual percentage change (AAPC) were estimated using Joinpoint regression. A total of 5,050,271 arrhythmia-related deaths were recorded, with the overall AAMR increasing from 111.4 in 1999 to 137.3 in 2023. Mortality rates declined significantly from 1999 to 2009 (APC: -1.04%; p = 0.003) but rose sharply from 2009 to 2018 (APC: 1.69%; p = 0.003), peaking in 2021 during the COVID-19 pandemic (APC: 8.63%; p < 0.001). A subsequent decline was observed from 2021 to 2023 (APC: -3.91%; p = 0.044). Males consistently exhibited higher AAMRs than females (137.2 vs. 95.3), as did non-Hispanic White individuals compared to other racial groups. Geographic disparities revealed higher mortality rates in Nonmetropolitan areas and the Midwest, with the highest AAMR observed in Oregon and the lowest in Hawaii. Despite an overall decline in arrhythmia-related mortality, recent increases, especially in West Virginia and among certain racial groups, highlight the need for targeted public health interventions.

Meta-Analysis of Racial and Ethnic Disparities in Rhythm Control Strategies for Atrial Fibrillation in the United States.

Meta-Analysis of Racial and Ethnic Disparities in Rhythm Control Strategies for Atrial Fibrillation in the United States.

COVID-19 Case-Fatality Rates in Michigan Are Higher for Arab Americans Compared With Non-Hispanic White Individuals for the Oldest Age Groups

The aim of this study was to estimate and compare the age-specific and sex-adjusted case-fatality rates (CFRs) among Arab Americans to Hispanic, non-Hispanic Black, non-Hispanic White, and Asian adults living in Michigan. Data from Michigan’s vital records, surveillance data (March 2020-July 2021), and an Arab/Chaldean surname algorithm were used. We used χ2 tests to determine statistically significant differences between groups. Logistic regression was used to estimate age-specific and sex-adjusted CFRs. Arab Americans had a lower CFR of 1.54% compared with Asian (1.97%), non-Hispanic White (2.17%), and non-Hispanic Black adults (3.36%), regardless of sex. For those 80 years of age or older, Arab American (30.72%) and Asian adults (31.47%) had higher CFR compared with the other racial or ethnic groups, with non-Hispanic White adults displaying a lower CFR of 18.28%. An Arab American ethnic identifier would likely increase the visibility of this population so that they can be included in the efforts to increase awareness, testing, and prevention strategies of COVID-19 or similar pandemics that might be facing us in the future.

Racial and ethnic disparities in post-acute care service utilization after stroke.

Racial and ethnic disparities in post-acute care service utilization after stroke.

Racial and ethnic disparities on the heart transplant waiting list.

Racial and ethnic disparities on the heart transplant waiting list.

Characterization of xylazine-related overdose deaths in Maryland (2020-2023).

Characterization of xylazine-related overdose deaths in Maryland (2020-2023).

Alcohol, Cannabis, and nicotine use during early pregnancy and infant hearing loss.

Alcohol, Cannabis, and nicotine use during early pregnancy and infant hearing loss.