ABSTRACT
SESSION TITLE: Racial Disparities in Pulmonary Embolism Risk Factors and Mortality in the SESSION TYPE: Original Investigations PRESENTED ON: 10/17/2022 1:30 pm - 2:30 pm PURPOSE: Racial disparities in pulmonary embolism (PE) related mortality rates have been reported for decades in the United States (US). The risk factors contributing to the observed disparity remain unclear. Our objective is to examine recent PE-related mortality trends and PE risk factors by race. We hypothesize racial disparity gap in PE-related mortality and risk factors has persisted and might have widened with the COVID 19 pandemic. METHODS: The Centers for Disease Control and Prevention (CDC) wide-ranging online data for epidemiologic research for both underlying cause of death (UCOD) and multiple causes of death (MCOD) in the US between the years 1999-2020 was used for this study. Non-Hispanic black (NHB) and non-Hispanic white (NHW) decedents aged 25 years and older with an ICD-10 code for PE (I26) were included. Age-adjusted mortality rates (AAMR) with 95% Confidence Intervals (CIs) were computed by race for age groups, year, Health & Human Services (HHS) regions, and urbanization and PE risk factors. Risk factors examined were trauma, cancer, cardiovascular diseases, obesity, sepsis, chronic lower respiratory diseases, and COVD-19 among PE decedents. RESULTS: Between the years 1999-2020, PE was the UCOD in 168,540 decedents, with 137,128 (81.4%) NHWs and 31,412 (18.6%) NHBs. The overall age-adjusted mortality rate (AAMR) decreased from 1999(5.3;95% CI, 5.2 - 5.4) to 2009(3.6;95% CI, 3.5 - 3.7), and then increased from 2010(3.8;95% (3.7 - 3.8) to 2020(4.2;95% CI, 4.1 - 4.3).There was a steep rise in the overall AAMR for 2020 (4.2;95% CI, 4.1 - 4.3) compared to the year prior 2019 (3.9;95% CI, 3.8 - 4.0) with highest annual % change among NHBs when compared to NHWs (NHB men (13%), NHB women (15%), NHW men (8.3%), NHW women (6%).) NHB men (AAMR 7.2;95% CI, 7.1-7.4) and NHB women (AAMR 6.6;95% CI, 6.5-6.7) had 2-fold higher AAMR compared to NHW men (AAMR 3.8;95% CI, 3.8-3-9) and NHW women (AAMR 3.7;95% CI, 3.7-3.7). Similar trends were also noted in geographical regions. The highest AAMRs were in HHS regions 3, 4, 5,6, 7, and 8. Within these HHS regions, NHBs and NHWs who resided in small metro and non-metropolitan areas had the highest AAMRs. However, NHB-NHW disparity in AAMR was seen in all 10 HHS regions and Urbanization. When risk factors such as trauma, cancer, obesity, cardiovascular diseases, sepsis, and chronic lower respiratory diseases were each mentioned as MCOD with PE decedents, rates varied by risk factor but NHBs had consistently higher AAMR than NHWs. CONCLUSIONS: We showed that PE-related mortality has increased over the past decade and racial disparities persisted and varied by gender, region, urbanization, and risk factors. The decades-long disparity observed in PE-related mortality may be narrowed by allocating resources to the management of common comorbidities. CLINICAL IMPLICATIONS: Racial disparity in PE-related mortality is related to comorbidities listed in MCOD data. DISCLOSURES: No relevant relationships by Isaac Ikwu No relevant relationships by Alem Mehari No relevant relationships by Lamiaa Rougui
ABSTRACT
As cardiovascular diseases are still a major cause of death in most countries, it is still relevant to look into treatment of such diseases. Dyslipidemia is one of the important identified risk factors for cardiovascular diseases. As this is largely driven by lifestyle and diet, it may be difficult to control it with lifestyle modifications alone. Currently, Statins remains to be the mainstay therapy for dyslipidemia but this is also met by problems within certain patient population. The drug may be contraindicated in certain patient groups;some patients tend to not respond to Statins;while certain patients may not tolerate the adverse events. This study looked into available literature on studies done on dyslipidemia using plant-based formulations using randomized clinical trial. Based on the review conducted, there are several plant-based formations with potential to be similar in efficacy to Statins. Some of the plants used are abundant or may be easily sourced. With the increasing popularity of food supplements or nutraceuticals, exploration on the potential of plant-based products is attractive. Despite the promising results of some studies, these will need further investigations and targeting a larger population size. Formulation options may need to be explored also focused on its stability. © RJPT All right reserved.