TY - JOUR
T1 - Disparities in the Use of Cardiac Rehabilitation in African Americans
AU - Mathews, Lena
AU - Akhiwu, Ofure
AU - Mukherjee, Monica
AU - Blumenthal, Roger S.
AU - Matsushita, Kunihiro
AU - Ndumele, Chiadi E.
N1 - Funding Information:
Dr. Mathews was supported by Diversity Supplement under ARIC Contract Grant Number Contract HHSN268201700002I/75N92019F00074 from the National Heart, Lung, and Blood Institute, National Institutes of Health (NIH), and the Johns Hopkins University Clinician Scientist Award.
Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2022/5
Y1 - 2022/5
N2 - Purpose of review: Cardiac rehabilitation (CR) is a comprehensive outpatient program that reduces the risk of mortality and recurrent events and improves functional status and quality of life for patients recovering from acute cardiovascular disease (CVD) events. Among individuals with established CVD, African Americans have a higher risk of major cardiac events, which underscores the importance of CR use among African Americans. However, despite their high likelihood of adverse outcomes, CR is poorly utilized in African Americans with CVD. We review data on CR utilization among African Americans, barriers to participation, and the implications for policy and practice. Recent findings: Although established as a highly effective secondary prevention strategy, CR is underutilized in general, but especially by African Americans. Notwithstanding efforts to increase CR participation among all groups, participation rates remain low for African Americans and other minorities compared to Non-Hispanic Whites. The low CR participation rates by African Americans can be attributed to an array of factors including differential referral patterns, access to care, and socioeconomic factors. There are several promising strategies to improve CR participation which include promoting evidence-based guidelines, reducing barriers to access, novel CR delivery modalities, including more African Americans in CR clinical research, and increasing diversity in the CR workforce. Summary: African Americans with CVD events are less likely to be referred to, enroll in, and complete CR than Non-Hispanic Whites. There are many factors that impact CR participation by African Americans. Initiatives at the health policy, health system, individual, and community level will be needed to reduce these disparities in CR use.
AB - Purpose of review: Cardiac rehabilitation (CR) is a comprehensive outpatient program that reduces the risk of mortality and recurrent events and improves functional status and quality of life for patients recovering from acute cardiovascular disease (CVD) events. Among individuals with established CVD, African Americans have a higher risk of major cardiac events, which underscores the importance of CR use among African Americans. However, despite their high likelihood of adverse outcomes, CR is poorly utilized in African Americans with CVD. We review data on CR utilization among African Americans, barriers to participation, and the implications for policy and practice. Recent findings: Although established as a highly effective secondary prevention strategy, CR is underutilized in general, but especially by African Americans. Notwithstanding efforts to increase CR participation among all groups, participation rates remain low for African Americans and other minorities compared to Non-Hispanic Whites. The low CR participation rates by African Americans can be attributed to an array of factors including differential referral patterns, access to care, and socioeconomic factors. There are several promising strategies to improve CR participation which include promoting evidence-based guidelines, reducing barriers to access, novel CR delivery modalities, including more African Americans in CR clinical research, and increasing diversity in the CR workforce. Summary: African Americans with CVD events are less likely to be referred to, enroll in, and complete CR than Non-Hispanic Whites. There are many factors that impact CR participation by African Americans. Initiatives at the health policy, health system, individual, and community level will be needed to reduce these disparities in CR use.
KW - Cardiac rehabilitation
KW - Cardiovascular disease
KW - Disparities
KW - Race
KW - Utilization
UR - http://www.scopus.com/inward/record.url?scp=85129544309&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85129544309&partnerID=8YFLogxK
U2 - 10.1007/s12170-022-00690-2
DO - 10.1007/s12170-022-00690-2
M3 - Review article
C2 - 35573267
AN - SCOPUS:85129544309
SN - 1932-9520
VL - 16
SP - 31
EP - 41
JO - Current Cardiovascular Risk Reports
JF - Current Cardiovascular Risk Reports
IS - 5
ER -