by A recent study conducted by investigators from Weill Cornell Medicine and NewYork-Presbyterian has found that removing race information from cardiovascular risk calculators does not affect patients’ risk scores. The study, published in JAMA Cardiology on December 6, adds to the growing body of evidence questioning the use of race in medical decision-making.
Currently, doctors use cardiovascular risk assessments that include personal health information, gender, and race to gauge the likelihood of a person developing heart disease. The risk score derived from these assessments then guides lifestyle changes and medication prescriptions to prevent disease.
The study demonstrated that removing race from the atherosclerotic cardiovascular pooled cohort risk equations did not change a patient’s risk score. Additionally, the study found that adding social determinants of health into the equation also did not have an effect. This suggests that the use of race in cardiovascular risk prediction may need to be rethought.
Dr. Arnab Ghosh, the lead author of the study and an assistant professor of medicine at Weill Cornell Medicine, stated that race should be viewed as a social construct that affects individuals over the course of their lives, rather than a biological construct. The paradigm is changing, as evidenced by the American Heart Association’s development of a new cardiovascular risk calculator that no longer includes race as a factor.
The use of race in clinical decision-making has come under scrutiny in recent years. Several studies have shown that the use of race in assessments for kidney function and lung disease leads to disparities in care for minority patients. In light of these developments, Dr. Ghosh and his colleagues wanted to examine how removing race from cardiovascular risk assessments would affect accuracy.
The team analyzed data from the Reasons for Geographic And Racial Differences in Stroke (REGARDS) study, which includes over 30,000 Black and white participants aged 45 to 79. The study included 12,000 of these participants and analyzed outcomes for up to 10 years.
Despite the well-documented racial and ethnic disparities in heart disease outcomes, the researchers were surprised to find that race and social determinants of health had no effect on risk outcome. They concluded that measuring risk factors like blood pressure, diabetes status, and cholesterol could accurately predict risk without using race.
Dr. Ghosh explained that the social impact of race on an individual’s blood pressure and other health factors is still present, which may explain why the calculators can accurately predict risk even without explicitly using race. Additionally, the researchers noted that the older age of the participants in the REGARDS study may have influenced the results, as the effects of social determinants of health accumulate over a lifetime.
Moving forward, Dr. Ghosh and his colleagues plan to assess the use of race and social determinants in risk calculations across a patient’s lifespan. They aim to develop risk prediction models that incorporate traditional cardiovascular risk factors as well as nontraditional ones, such as the effects of living in racially segregated communities.
The study’s findings highlight the need for clinicians and scientists to consider how to address the health effects of race as a social construct. By doing so, they hope to reduce health disparities in cardiovascular outcomes.
*Note:
1. Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it
