Author Interviews, Brigham & Women's - Harvard, Heart Disease, Race/Ethnic Diversity / 05.08.2019
TRICARE Study Finds No Racial Disparities in Heart Surgery Care
MedicalResearch.com Interview with:
[caption id="attachment_50551" align="alignleft" width="200"] Dr. Chaudhary[/caption]
Muhammad Ali Chaudhary, MD
Research Scientist
Center for Surgery and Public Health
Department of Surgery
Brigham and Women’s Hospital
Harvard Medical School
Harvard T. H. Chan School of Public Health
MedicalResearch.com: What is the background for this study?
Response: Many studies have documented disparities in cardiovascular care for minorities, specifically African Americans compared to white patients. Coronary artery bypass grafting (CABG) is a common procedure in the United States, and the outcomes and post-surgical care for African Americans tend to be worse. We examined whether patients insured through TRICARE — a universal insurance and equal-access integrated healthcare system that covers more than 9 million active-duty members, veterans and their families — experienced these disparities. We found no racial disparities in quality-of-care outcomes, providing insights about the potential impacts of universal insurance and an equal-access health care system.
The study included 8,183 TRICARE patients, aged 18-64, who had undergone CABG. The study took its data from TRICARE health care claims from the Military Health System Data Repository for the years of 2006 to 2014.
Dr. Chaudhary[/caption]
Muhammad Ali Chaudhary, MD
Research Scientist
Center for Surgery and Public Health
Department of Surgery
Brigham and Women’s Hospital
Harvard Medical School
Harvard T. H. Chan School of Public Health
MedicalResearch.com: What is the background for this study?
Response: Many studies have documented disparities in cardiovascular care for minorities, specifically African Americans compared to white patients. Coronary artery bypass grafting (CABG) is a common procedure in the United States, and the outcomes and post-surgical care for African Americans tend to be worse. We examined whether patients insured through TRICARE — a universal insurance and equal-access integrated healthcare system that covers more than 9 million active-duty members, veterans and their families — experienced these disparities. We found no racial disparities in quality-of-care outcomes, providing insights about the potential impacts of universal insurance and an equal-access health care system.
The study included 8,183 TRICARE patients, aged 18-64, who had undergone CABG. The study took its data from TRICARE health care claims from the Military Health System Data Repository for the years of 2006 to 2014.
Dr. Dunn[/caption]
Dr. Amy Dunn, PhD
Kaczorowski lab
The Jackson Laboratory
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Environmental factors, such as a poor diet, are known risk factors for Alzheimer’s disease. But the mechanisms are complex, and it is not known how such environmental perturbations interact with individual genetic variation to confer disease risk. Previous studies have not adequately addressed how the combination of genetic variant and environmental factors combine to alter cognitive response to a poor diet.
To investigate gene-by-environment interactions, we fed either a normal diet or a high-fat diet to a genetically diverse Alzheimer’s disease mouse model population starting at six months of age and monitored metabolic and cognitive function.
We observed accelerated working memory decline in the mice on the high-fat diet after eight weeks, with substantial gene-by diet effects on both cognitive and metabolic traits.
Metabolic dysfunction was more closely related to cognitive function in mice carrying Alzheimer’s mutations than in those without. Interestingly, the high-fat diet affected metabolic function differently in female versus male mice. 
Dr. Hui Wang[/caption]
Prof Hui Wang PhD
Wuhan University
China
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: We started our work in the adverse outcome of maternal caffeine intake during pregnancy about 15 years ago. Then, we found that prenatal caffeine intake could result in nonalcoholic fatty liver disease in the offspring. However, the underlying mechanism was unclear.
So, we start the current work, and found that hat maternal caffeine intake disrupts liver development before and after birth, which might be the trigger of the adult non-alcoholic fatty liver disease in the offspring rats. Moreover, we further found that the fetal programming of liver glucocorticoid – insulin like growth factor 1 axis, a new endocrine axis first reported by our team, might participate in such process.
Kazuo Kitagawa, MD PhD
Department of Neurology
Tokyo Women's Medical University
Tokyo, Japan
MedicalResearch.com: What is the background for this study? What are the main findings
Response: Reduction in blood pressure (BP) reduces the rates of recurrent stroke, but the optimum BP target remained unclear.
The results of RESPECT Study together with up-dated meta-analysis showed the benefit of intensive blood pressure lowering (<130/80 mmHg) compared with standard BP lowering (<140/90 mmHg). 
Dr. Phelan[/caption]
Dermot Phelan, MD, PhD
Director of the Sports Cardiology Center
Cleveland Clinic in Cleveland, Ohio
MedicalResearch.com: What is the background for this study?
Response: It is well recognized that long-term elite endurance athletes are at higher risk of atrial fibrillation. We wished to evaluate whether this held true for primarily strength-type athletes. We had the opportunity to screen almost 500 former NFL athletes. It became clear that we were seeing more atrial fibrillation than one would expect during the screenings.
