Women, Elderly, Minorities Underrepresented In Cardiovascular Studies

MedicalResearch.com Interview with:
Marwan Badri MBChB, MRCP
Cardiovascular disease fellow
Lankenau Medical Center
Wynnewood Pa

Medical Research : What is the background for this study?

Dr. Badri: Recent years witnessed increased emphasis of the role of clinical guidelines in cardiovascular care. Physicians are encouraged to practice within the framework of major society guidelines to deliver better, more cost-effective patient care. It is therefore vital that the recommendations in these guidelines are applicable to most of the patient population. Since some clinical trials have been shown in the past to unfavorably exclude women, racial minorities and elderly patients, we conducted this study to see if the clinical trials used to form the American College of Cardiology/American Heart Association adequately represent these patient groups.

Medical Research : What are the main findings?

Dr. Badri: The main findings of the study was that women, elderly patients and those from racial minorities are under-represented in the randomized trials used in the ACC/AHA guidelines. Additionally, only a small percentage of the trials reported patients’ race. These findings raise the concern that the cardiovascular guidelines may not be applicable on all patients.

Medical Research : What should patients and clinicians take away from this report?

Dr. Badri: While these findings don’t discount the importance of following guidelines recommendations, since they are the best available clinical evidence, they do emphasize how vital it is to improve patient recruitment in future clinical trials, to make the findings of these trials more applicable to most patients. This will further help to understand the different effects certain disease processes have on different patients, further advancing our knowledge of cardiovascular diseases – the most common cause of mortality in developed as well as many developing countries.

Citation:

Sardar M, Badri M, Prince CT, Seltzer J, Kowey PR. Underrepresentation of Women, Elderly Patients, and Racial Minorities in the Randomized Trials Used for Cardiovascular Guidelines. JAMA Intern Med. Published online September 29, 2014. doi:10.1001/jamainternmed.2014.4758.