Native Hawaiian and Pacific Islander adults have third highest cardiovascular death rate in the U.S.

Embargoed for release until 5:00 p.m. ET on Monday 14 October 2024    

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Below please find summaries of new articles that will be published in the next issue of Annals of Internal Medicine. The summaries are not intended to substitute for the full articles as a source of information. This information is under strict embargo and by taking it into possession, media representatives are committing to the terms of the embargo not only on their own behalf, but also on behalf of the organization they represent.         
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1. Native Hawaiian and Pacific Islander adults have third highest cardiovascular death rate in the U.S. 

Abstract: https://www.acpjournals.org/doi/10.7326/M24-0801     

URL goes live when the embargo lifts          

A study of nationwide mortality data found that Native Hawaiian Pacific Islander (NHPI) adults have substantially higher cardiovascular death rates than Asian adults and the third highest cardiovascular death rate in the United States behind Black and White adults. Previous studies of cardiovascular disease (CVD) mortality in this population aggregated the NHPI population with the Asian population. Separating these two groups highlights important differences in CVD death rates, which is important for informing prevention strategies. The findings are published in Annals of Internal Medicine.  

National CVD mortality data for the NHPI population are needed to inform clinical practice for this population. Researchers from the National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention studied mortality data from a national database for adults older than 35 to describe CVD mortality among NHPI adults. Cause of death was identified using data from the International Classification of Diseases and stratified according to the race and Hispanic ethnicity groups selected on the death certificate, which are reported by the surviving next of kin or other informants or are based on observation. The data showed 10,870 CVD deaths among NHPI between 2018-2022 with an estimated mean of 2,174 deaths per year. About 40% of NHPI deaths were attributed to coronary heart disease and about 19% to cerebrovascular disease. CVD age-standardized mortality rates, or ASMRs, were 1.5 times higher among NHPI adults compared with Asian adults. In addition, the authors note a concerning finding that more than one third of CVD deaths among NHPI adults occurred among those younger than 65 years, indicating a high prevalence of potentially premature CVD deaths. Collectively, these results signal a need for focused interventions to promote cardiovascular health and prevent CVD among the NHPI population. 

The authors of an accompanying editorial from the University of Hawaii and the University of Michigan say that these findings highlight an important issue. When racial and ethnic populations are aggregated, conclusions may unintentionally mislead the public, health care providers, and policymakers on the “actual” health risks, resilience factors, and measured outcomes that are vital to developing effective policies and prevention programs. However, the authors emphasize that more effective tools and nuanced approaches are needed to disentangle the construct of race and ethnicity as only one factor that may influence the health status of the ever-growing racial diversity of the US population 

Media contacts: For an embargoed PDF, please contact Angela Collom at acollom@acponline.org. To speak with corresponding author Rebecca C. Woodruff, PhD, MPH, please email okp9@cdc.gov. 

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2. Doctor/patient survey reveals pros and cons of billing for portal emails 

Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-24-00560  

URL goes live when the embargo lifts          

According to a brief research report published in Annals of Internal Medicine, policies that require billing patients for emailing through the patient portal may change communication behavior between patients and physicians. Physicians believe patients may withhold important information to avoid charges, and patients may anticipate faster, more detailed replies, viewing it as a premium service.  According to the researchers, health systems may want to review the advantages and disadvantages of similar policies before deciding on an appropriate implementation strategy. 

Researchers from the Center for Value-Based Care Research, Cleveland Clinic interviewed 13 patients and 16 physicians using tailored questions to understand perceptions of billing policy and its influence on workflow, distress, communication, and quality. Patients and physicians were given separate surveys on the same topic. Their responses showed differences in attitudes and potential behaviors between the two groups. While patients viewed billing for emails as a negative at first, they said they understood that the method could be abused by some. Physicians hoped billing would reduce the number of messages or mean that time would be given within the workday to answer them. Both physicians and patients expressed confusion over billing policy. Patients did not know whether their message would require a little or a lot of physician time and physicians weren't sure how to bill when multiple actions might be required within the patient record and between patient message requests. The physicians said they may choose not to charge patients with difficult socioeconomic circumstances. The researchers say it is important to consider these potential consequences before these billing policies become widespread. 

Media contacts: For an embargoed PDF, please contact Angela Collom at acollom@acponline.org. To speak with corresponding author Jordan M. Alpert, PhD, please email Kathryn Ely at elyk@ccf.org.  

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Late Breaker also published in this issue: 

Opportunities for Innovation in Smoking Cessation Therapies: A Perspective from the NIH and FDA 

Haider Warraich, Brian King, Wilson Compton, Evan Herrmann, Mary Thanh Hai, Robert Califf1 & Monica Bertagnolli  

Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-24-02318 

Media contacts: For an embargoed PDF, please contact Angela Collom at acollom@acponline.org. To speak with corresponding author Haider Warraich, please email haiderwarraich@gmail.com.