2024
Racial and Ethnic Disparities in Age-Specific All-Cause Mortality During the COVID-19 Pandemic
Faust J, Renton B, Bongiovanni T, Chen A, Sheares K, Du C, Essien U, Fuentes-Afflick E, Haywood T, Khera R, King T, Li S, Lin Z, Lu Y, Marshall A, Ndumele C, Opara I, Loarte-Rodriguez T, Sawano M, Taparra K, Taylor H, Watson K, Yancy C, Krumholz H. Racial and Ethnic Disparities in Age-Specific All-Cause Mortality During the COVID-19 Pandemic. JAMA Network Open 2024, 7: e2438918. PMID: 39392630, DOI: 10.1001/jamanetworkopen.2024.38918.Peer-Reviewed Original ResearchConceptsCOVID-19 public health emergencyNon-HispanicPublic health emergencyOther Pacific IslanderExcess mortalityAlaska NativesUS populationExcess deathsRates of excess mortalityCross-sectional study analyzed dataYears of potential lifeMortality relative riskNon-Hispanic whitesCross-sectional studyPacific IslandersStudy analyzed dataAll-cause mortalityEthnic groupsMortality disparitiesMortality ratioTotal populationDeath certificatesEthnic disparitiesMain OutcomesDecedent ageHypertension Trends and Disparities Over 12 Years in a Large Health System: Leveraging the Electronic Health Records
Brush J, Lu Y, Liu Y, Asher J, Li S, Sawano M, Young P, Schulz W, Anderson M, Burrows J, Krumholz H. Hypertension Trends and Disparities Over 12 Years in a Large Health System: Leveraging the Electronic Health Records. Journal Of The American Heart Association 2024, 13: e033253. PMID: 38686864, PMCID: PMC11179912, DOI: 10.1161/jaha.123.033253.Peer-Reviewed Original ResearchConceptsElectronic health recordsRegional health systemImprove hypertension careHealth systemHealth recordsHypertension careDiastolic blood pressureAge-adjusted prevalence ratesNon-Hispanic Black patientsPrevalence ratesLarger health systemCross-sectional analysisTransformation of medical dataLeveraging real-world dataHigh prevalence rateHypertension trendsHypertension prevalenceBlood pressureBlood pressure measurementsHypertension diagnosisPrimary outcomeNational trendsProportion of patientsAntihypertensive medicationsBlack patients
2022
Racism as a leading cause of death in the United States
Krumholz HM, Massey DS, Dorsey KB. Racism as a leading cause of death in the United States. The BMJ 2022, 376: o213. PMID: 35078777, DOI: 10.1136/bmj.o213.Peer-Reviewed Original ResearchBlack or African AmericanCause of DeathHealth Status DisparitiesHealthcare DisparitiesHumansRacismUnited States
2021
National Trends in Racial and Ethnic Disparities in Antihypertensive Medication Use and Blood Pressure Control Among Adults With Hypertension, 2011–2018
Lu Y, Liu Y, Dhingra LS, Massey D, Caraballo C, Mahajan S, Spatz ES, Onuma O, Herrin J, Krumholz HM. National Trends in Racial and Ethnic Disparities in Antihypertensive Medication Use and Blood Pressure Control Among Adults With Hypertension, 2011–2018. Hypertension 2021, 79: 207-217. PMID: 34775785, DOI: 10.1161/hypertensionaha.121.18381.Peer-Reviewed Original ResearchConceptsAntihypertensive medication usePoor hypertension controlOverall treatment rateLow control rateHypertension controlHypertension awarenessMedication useControl rateHispanic individualsEthnic differencesTreatment ratesBlack individualsGuideline-recommended medicationsBlood pressure controlWhite individualsNutrition Examination SurveyLow awareness rateAntihypertensive medicationsHypertensive peopleExamination SurveyIntensive medicationNational HealthAwareness rateEthnic disparitiesPressure controlDisparities in Excess Mortality Associated with COVID-19 — United States, 2020
Rossen LM, Ahmad FB, Anderson RN, Branum AM, Du C, Krumholz HM, Li SX, Lin Z, Marshall A, Sutton PD, Faust JS. Disparities in Excess Mortality Associated with COVID-19 — United States, 2020. MMWR Morbidity And Mortality Weekly Report 2021, 70: 1114-1119. PMID: 34411075, PMCID: PMC8375709, DOI: 10.15585/mmwr.mm7033a2.Peer-Reviewed Original ResearchMeSH KeywordsAdultAge DistributionAgedCOVID-19EthnicityHealth Status DisparitiesHumansMiddle AgedMortalityRacial GroupsUnited StatesYoung AdultConceptsMortality incidence ratesIncidence rateExcess mortalityAge groupsHighest excess mortality ratesExcess Mortality AssociatedGreater excess mortalityExcess mortality ratesAI/AN populationsNon-Hispanic American IndianNon-Hispanic blacksNational Vital Statistics SystemCOVID-19 pandemicPublic health messagingNon-Hispanic white populationRace/ethnicityVital Statistics SystemMortality AssociatedLack of adjustmentMortality rateExcess deathsAN populationsEthnic groupsHealth messagingHispanic personsTrends in Differences in Health Status and Health Care Access and Affordability by Race and Ethnicity in the United States, 1999-2018
Mahajan S, Caraballo C, Lu Y, Valero-Elizondo J, Massey D, Annapureddy AR, Roy B, Riley C, Murugiah K, Onuma O, Nunez-Smith M, Forman HP, Nasir K, Herrin J, Krumholz HM. Trends in Differences in Health Status and Health Care Access and Affordability by Race and Ethnicity in the United States, 1999-2018. JAMA 2021, 326: 637-648. PMID: 34402830, PMCID: PMC8371573, DOI: 10.1001/jama.2021.9907.Peer-Reviewed Original ResearchConceptsHealth care accessFair health statusSelf-reported health statusCare accessHealth statusWhite individualsEthnic differencesLatino/HispanicNational Health Interview Survey dataSerial cross-sectional studySelf-reported functional limitationsBlack individualsHealth Interview Survey dataLow incomeCross-sectional studyCross-sectional survey studyInterview Survey dataSelf-reported raceSelf-report measuresMAIN OUTCOMEUS adultsFunctional limitationsPercentage of peopleSignificant decreaseAdults
2020
Sex Differences in 1‐Year Health Status Following Percutaneous Coronary Intervention in Patients Without Acute Myocardial Infarction: Results From the China PEACE Prospective Study
Zheng X, Dreyer RP, Curtis JP, Liu S, Xu X, Bai X, Li X, Zhang H, Wang S, Masoudi FA, Spertus JA, Li J, Krumholz HM, Group F. Sex Differences in 1‐Year Health Status Following Percutaneous Coronary Intervention in Patients Without Acute Myocardial Infarction: Results From the China PEACE Prospective Study. Journal Of The American Heart Association 2020, 9: e014421. PMID: 32131687, PMCID: PMC7335522, DOI: 10.1161/jaha.119.014421.Peer-Reviewed Original ResearchConceptsPercutaneous coronary interventionAcute myocardial infarctionSAQ Summary ScoreCoronary interventionHealth status outcomesMyocardial infarctionHealth statusSummary scoresSAQ qualityAngina frequencyStatus outcomesPercutaneous coronary intervention studiesSAQ angina frequency scoreAngina frequency scoreCoronary Intervention StudyMarginal clinical significanceSAQ angina frequencyCardiac risk factorsChinese tertiary hospitalBackground Sex differencesSex differencesMultivariable adjustmentDiabetes mellitusTertiary hospitalLife scoresSex Differences in Symptom Phenotypes Among Patients With Acute Myocardial Infarction
Brush JE, Krumholz HM, Greene EJ, Dreyer RP. Sex Differences in Symptom Phenotypes Among Patients With Acute Myocardial Infarction. Circulation Cardiovascular Quality And Outcomes 2020, 13: e005948. PMID: 32063049, PMCID: PMC7041412, DOI: 10.1161/circoutcomes.119.005948.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultBiological Variation, IndividualFemaleHealth Status DisparitiesHumansInterviews as TopicMaleMiddle AgedMyocardial InfarctionPatient AdmissionPhenotypePredictive Value of TestsProspective StudiesRisk AssessmentRisk FactorsSex FactorsSpainSymptom AssessmentUnited StatesYoung AdultConceptsAcute myocardial infarctionMyocardial infarctionMedical recordsYoung womenDiagnosis of AMIObservational cohort studyMedical record abstractionSymptom phenotypeDiagnostic processAnalysis of symptomsVIRGO StudyCohort studyRecord abstractionIndividual patientsClinician's abilityDiagnosis rateStandardized interviewPhenotype subgroupsSymptomsSimilar findingsYoung adultsWomenMenInfarctionPatients
2019
Sex-Based Differences in Presentation, Treatment, and Complications Among Older Adults Hospitalized for Acute Myocardial Infarction
Nanna MG, Hajduk AM, Krumholz HM, Murphy TE, Dreyer RP, Alexander KP, Geda M, Tsang S, Welty FK, Safdar B, Lakshminarayan DK, Chaudhry SI, Dodson JA. Sex-Based Differences in Presentation, Treatment, and Complications Among Older Adults Hospitalized for Acute Myocardial Infarction. Circulation Cardiovascular Quality And Outcomes 2019, 12: e005691. PMID: 31607145, PMCID: PMC6913190, DOI: 10.1161/circoutcomes.119.005691.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAged, 80 and overComorbidityDisability EvaluationFemaleHealth Status DisparitiesHealthcare DisparitiesHumansLife StyleMaleMyocardial RevascularizationNon-ST Elevated Myocardial InfarctionPatient AdmissionPrevalenceProspective StudiesRisk AssessmentRisk FactorsSex FactorsSocial Determinants of HealthST Elevation Myocardial InfarctionTime FactorsTreatment OutcomeUnited StatesConceptsAcute myocardial infarctionSex-based differencesPercutaneous coronary interventionFunctional impairmentOlder adultsHospital complicationsCoronary interventionOlder patientsCoronary diseaseMyocardial infarctionAge-related functional impairmentsAge-associated functional impairmentsLower ratesPrior coronary diseaseObstructive coronary diseaseProspective observational studyNSTEMI subgroupSTEMI subgroupUnderwent revascularizationAcute myocardialChest painClinical presentationAMI subgroupRisk factorsHigh prevalenceDisparities in Socioeconomic Context and Association With Blood Pressure Control and Cardiovascular Outcomes in ALLHAT
Shahu A, Herrin J, Dhruva SS, Desai NR, Davis BR, Krumholz HM, Spatz ES. Disparities in Socioeconomic Context and Association With Blood Pressure Control and Cardiovascular Outcomes in ALLHAT. Journal Of The American Heart Association 2019, 8: e012277. PMID: 31362591, PMCID: PMC6761647, DOI: 10.1161/jaha.119.012277.Peer-Reviewed Original ResearchConceptsBlood pressure controlLow-income sitesCardiovascular outcomesPressure controlALLHAT participantsPoor blood pressure controlEnd-stage renal diseaseHospitalization/mortalityAdverse cardiovascular eventsCardiovascular risk factorsWorse cardiovascular outcomesHigh blood pressureStandardized treatment protocolRandomized clinical trialsBackground Observational studiesLow socioeconomic statusHighest income quintileAngina hospitalizationCardiovascular eventsCause mortalityCoronary revascularizationClinical characteristicsBlood pressureRenal diseaseClinical outcomes
2018
Racial Disparities in Patient Characteristics and Survival After Acute Myocardial Infarction
Graham GN, Jones PG, Chan PS, Arnold SV, Krumholz HM, Spertus JA. Racial Disparities in Patient Characteristics and Survival After Acute Myocardial Infarction. JAMA Network Open 2018, 1: e184240. PMID: 30646346, PMCID: PMC6324589, DOI: 10.1001/jamanetworkopen.2018.4240.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionWhite patientsBlack patientsMortality rate differencesMortality ratePatient characteristicsMyocardial infarctionPropensity scoreAcute Myocardial Infarction Patients' Health Status (TRIUMPH) registrySelf-identified black patientsObserved survival differencesNational Death IndexTime of admissionLower propensity scoreProspective registryClinical characteristicsCohort studyDeath IndexHighest quintileBlack raceC-statisticSurvival differencesWorse outcomesMAIN OUTCOMEPatientsAssociation of Racial and Socioeconomic Disparities With Outcomes Among Patients Hospitalized With Acute Myocardial Infarction, Heart Failure, and Pneumonia
Downing NS, Wang C, Gupta A, Wang Y, Nuti SV, Ross JS, Bernheim SM, Lin Z, Normand ST, Krumholz HM. Association of Racial and Socioeconomic Disparities With Outcomes Among Patients Hospitalized With Acute Myocardial Infarction, Heart Failure, and Pneumonia. JAMA Network Open 2018, 1: e182044. PMID: 30646146, PMCID: PMC6324513, DOI: 10.1001/jamanetworkopen.2018.2044.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBlack PeopleCohort StudiesFee-for-Service PlansFemaleHealth Status DisparitiesHeart FailureHospitalizationHospitalsHumansMaleMedicareMiddle AgedMyocardial InfarctionOutcome Assessment, Health CarePneumoniaRacial GroupsRetrospective StudiesSocial ClassUnited StatesWhite PeopleConceptsAcute myocardial infarctionRisk-standardized mortality ratesRisk-standardized readmission ratesReadmission ratesHeart failureMyocardial infarctionMortality rateIntraclass correlation coefficientAnalysis cohortBlack patientsHospital proportionSocioeconomic disparitiesHospital analysisRisk-standardized outcomesRisk-standardized ratesRetrospective cohort studySocioeconomic statusNeighborhood income levelHospital performanceHospital outcomesCohort studyNumber of hospitalsBroader systemic effectsPatient raceMAIN OUTCOMESex Differences in Omega‐3 and ‐6 Fatty Acids and Health Status Among Young Adults With Acute Myocardial Infarction: Results From the VIRGO Study
Lu Y, Ding Q, Xu X, Spatz ES, Dreyer RP, D'Onofrio G, Caulfield M, Nasir K, Spertus JA, Krumholz HM. Sex Differences in Omega‐3 and ‐6 Fatty Acids and Health Status Among Young Adults With Acute Myocardial Infarction: Results From the VIRGO Study. Journal Of The American Heart Association 2018, 7: e008189. PMID: 29848494, PMCID: PMC6015388, DOI: 10.1161/jaha.117.008189.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionHealth status scoresArachidonic acidVIRGO StudyStatus scoreMyocardial infarctionHealth statusPoorer health status outcomesYoung menPatient-reported health statusYoung womenOmega-3 fatty acidsSex differencesPatient-reported outcomesFatty acidsHealth status outcomesCardiovascular outcomesClinical characteristicsAdjusted analysisAMI patientsRisk factorsUS adultsStatus outcomesOmega-3Women 1Comparison of Prevalence, Awareness, Treatment, and Control of Cardiovascular Risk Factors in China and the United States
Lu Y, Wang P, Zhou T, Lu J, Spatz ES, Nasir K, Jiang L, Krumholz HM. Comparison of Prevalence, Awareness, Treatment, and Control of Cardiovascular Risk Factors in China and the United States. Journal Of The American Heart Association 2018, 7: e007462. PMID: 29374046, PMCID: PMC5850247, DOI: 10.1161/jaha.117.007462.Peer-Reviewed Original ResearchMeSH KeywordsAgedAntihypertensive AgentsAttitude of Health PersonnelBlood GlucoseBlood PressureBody Mass IndexCardiovascular DiseasesChinaDiabetes MellitusDyslipidemiasFemaleHealth Knowledge, Attitudes, PracticeHealth Status DisparitiesHumansHypertensionHypolipidemic AgentsLipidsLongitudinal StudiesMaleMiddle AgedNutrition SurveysObesityPractice Patterns, Physicians'PrevalencePrognosisRisk AssessmentRisk FactorsTime FactorsUnited StatesWaist CircumferenceConceptsHigher stroke prevalenceCardiovascular risk factorsHigh-sensitivity C-reactive proteinBody mass indexC-reactive proteinRisk factorsBlood pressureWaist circumferenceMass indexStroke prevalenceCardiovascular risk factor profileHigher mean blood pressureControl of hypertensionMean blood pressureBlood pressure levelsRisk factor profileComparison of prevalenceRepresentative population sampleLower ratesDyslipidemia awarenessSevere hypertensionHemoglobin A1cHypertension treatmentControl ratePlasma glucose
2017
Young Women With Acute Myocardial Infarction
Dreyer RP, Sciria C, Spatz ES, Safdar B, D'Onofrio G, Krumholz HM. Young Women With Acute Myocardial Infarction. Circulation Cardiovascular Quality And Outcomes 2017, 10: e003480. PMID: 28228455, PMCID: PMC5502480, DOI: 10.1161/circoutcomes.116.003480.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionYoung womenMyocardial infarctionManagement of AMIPost-AMI periodContinuum of careCoronary diseaseAged menHigh riskWorse recoveryWomenInfarctionHighlight gapsRecent studiesDifferent mechanismsMorbidityHospitalMortalityEpidemiologyPublic awarenessDiseaseDiagnosisCareSex Differences in Inflammatory Markers and Health Status Among Young Adults With Acute Myocardial Infarction
Lu Y, Zhou S, Dreyer RP, Spatz ES, Geda M, Lorenze NP, D'Onofrio G, Lichtman JH, Spertus JA, Ridker PM, Krumholz HM. Sex Differences in Inflammatory Markers and Health Status Among Young Adults With Acute Myocardial Infarction. Circulation Cardiovascular Quality And Outcomes 2017, 10: e003470. PMID: 28228461, PMCID: PMC5459381, DOI: 10.1161/circoutcomes.116.003470.Peer-Reviewed Original ResearchMeSH Keywords1-Alkyl-2-acetylglycerophosphocholine EsteraseAdolescentAdultAge of OnsetBiomarkersChi-Square DistributionComorbidityC-Reactive ProteinFemaleHealth Status DisparitiesHumansInflammation MediatorsLinear ModelsMaleMiddle AgedMultivariate AnalysisMyocardial InfarctionProspective StudiesRisk AssessmentRisk FactorsSex FactorsSocioeconomic FactorsUnited StatesUp-RegulationYoung AdultConceptsHigh-sensitivity C-reactive proteinAcute myocardial infarctionHigher inflammatory levelsInflammatory markersPoor health statusHealth statusYoung womenMyocardial infarctionInflammatory levelsTargeted anti-inflammatory treatmentsElevated inflammatory markersResidual cholesterol riskResidual inflammatory riskSex differencesAnti-inflammatory treatmentAnti-inflammatory therapyC-reactive proteinHigher mortality riskYoung menPhospholipase A2Years of ageCardiovascular outcomesMultivariable adjustmentPatient characteristicsSecondary prevention
2016
Population Well-Being Measures Help Explain Geographic Disparities In Life Expectancy At The County Level
Arora A, Spatz E, Herrin J, Riley C, Roy B, Kell K, Coberley C, Rula E, Krumholz HM. Population Well-Being Measures Help Explain Geographic Disparities In Life Expectancy At The County Level. Health Affairs 2016, 35: 2075-2082. PMID: 27834249, PMCID: PMC5150263, DOI: 10.1377/hlthaff.2016.0715.Peer-Reviewed Original ResearchFemaleGeographyHealth Status DisparitiesHumansLife ExpectancyLocal GovernmentMalePopulation HealthPovertySocial ClassParticipation of the elderly, women, and minorities in pivotal trials supporting 2011–2013 U.S. Food and Drug Administration approvals
Downing NS, Shah ND, Neiman JH, Aminawung JA, Krumholz HM, Ross JS. Participation of the elderly, women, and minorities in pivotal trials supporting 2011–2013 U.S. Food and Drug Administration approvals. Trials 2016, 17: 199. PMID: 27079511, PMCID: PMC4832528, DOI: 10.1186/s13063-016-1322-4.Peer-Reviewed Original ResearchMeSH KeywordsAdultAge FactorsAgedClinical Trials as TopicCross-Sectional StudiesDatabases, FactualDrug ApprovalEthnicityFemaleHealth Status DisparitiesHealthcare DisparitiesHumansMaleMiddle AgedMinority GroupsPatient SelectionSex FactorsTime FactorsUnited StatesUnited States Food and Drug AdministrationConceptsSubgroup efficacy analysesPivotal trialsEfficacy analysisNovel therapeuticsSubgroup analysisTrial participantsU.S. FoodMean proportionAvailable FDA documentsCross-sectional studyDrug Administration approvalBasis of approvalYears of ageTrial patientsElderly patientsMedian ageBlack patientsAsian patientsAdministration approvalClinical studiesFDA reviewersPatientsHispanic participantsTrialsDemographic characteristicsSlow Gait Speed and Risk of Mortality or Hospital Readmission After Myocardial Infarction in the Translational Research Investigating Underlying Disparities in Recovery from Acute Myocardial Infarction: Patients' Health Status Registry
Dodson JA, Arnold SV, Gosch KL, Gill TM, Spertus JA, Krumholz HM, Rich MW, Chaudhry SI, Forman DE, Masoudi FA, Alexander KP. Slow Gait Speed and Risk of Mortality or Hospital Readmission After Myocardial Infarction in the Translational Research Investigating Underlying Disparities in Recovery from Acute Myocardial Infarction: Patients' Health Status Registry. Journal Of The American Geriatrics Society 2016, 64: 596-601. PMID: 26926309, PMCID: PMC4803531, DOI: 10.1111/jgs.14016.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionMyocardial infarctionSlow gaitHospital readmissionGait speedOlder adultsCox proportional hazards regressionMarker of frailtySlow gait speedTranslational researchProportional hazards regressionOutcomes 1 yearRisk of mortalityAssessment 1 monthBaseline characteristicsObservational cohortClinical factorsDiabetes mellitusHeart failureHazards regressionPrognostic importancePrognostic valueHigh prevalenceInfarctionReadmissionSex Differences in Clinical Profiles and Quality of Care Among Patients With ST‐Segment Elevation Myocardial Infarction From 2001 to 2011: Insights From the China Patient‐Centered Evaluative Assessment of Cardiac Events (PEACE)‐Retrospective Study
Du X, Spatz ES, Dreyer RP, Hu S, Wu C, Li X, Li J, Wang S, Masoudi FA, Spertus JA, Nasir K, Krumholz HM, Jiang L, Group F. Sex Differences in Clinical Profiles and Quality of Care Among Patients With ST‐Segment Elevation Myocardial Infarction From 2001 to 2011: Insights From the China Patient‐Centered Evaluative Assessment of Cardiac Events (PEACE)‐Retrospective Study. Journal Of The American Heart Association 2016, 5: e002157. PMID: 26903002, PMCID: PMC4802449, DOI: 10.1161/jaha.115.002157.Peer-Reviewed Original ResearchConceptsST-segment elevation myocardial infarctionElevation myocardial infarctionQuality of careEvidence-based therapiesMyocardial infarctionClinical profileHospitalization ratesST-segment elevation myocardial infarction presentationSex differencesMyocardial infarction presentationYounger age groupsProportion of womenMyocardial infarction hospitalizationsEarly aspirinHospital deathCardiac eventsHospital admissionMedian ageSymptom onsetChina PatientRetrospective studyAdmission timeHigh riskSex disparitiesPatients