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Social Determinants

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Precision Medicine in Cardiovascular Disease Prevention

Abstract

Various structural barriers have historically predisposed socially disadvantaged populations to increased risk of cardiovascular disease (CVD). Sociodemographic disparities in cardiovascular care and outcomes are pervasive, and affect marginalized population groups adversely, and disproportionately. To a large extent, these disparities are explained by social determinants of health (SDOH)—the conditions in which individuals live and work, procreate and grow old, form social networks, and seek and provide help. Despite their well-documented role in determining overall health and wellbeing, SDOH remain grossly under-utilized in contemporary cardiovascular medicine. In particular, SDOH provide unique opportunities to tailor medical care to the individual patient, and are documented to improve outcomes when appropriately integrated into clinical care. However, current precision medicine approaches rarely incorporate SDOH into personalized decision management tools, which potentially restricts the benefits of precision health on both an individual and population level. In this chapter, we present an exhaustive framework to (i) highlight the association between SDOH and CVD (ii) identify high-risk populations that may benefit greatly from individually tailored cardiovascular care, and (iii) advance the development, and refinement of SDOH-informed precision care models for CVD, with implications for population cardiovascular health. The proposed framework is discussed in the context of historical inequities in health and health care in the US.

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Authors and Affiliations

  1. Center for Outcomes Research, Houston Methodist, Houston, TX, USA

    Zulqarnain Javed, Miguel Cainzos-Achirica & Bita Kash

  2. Department of Medicine, Carle Foundation Hospital, Urbana, IL, USA

    Hashim Jilani

  3. Houston Methodist Hospital. Houston Methodist Research Institute, Houston, TX, USA

    Tamer Yahya & Prachi Dubey

  4. West Virginia University, Morgantown, WV, US

    Safi U. Khan

  5. Milken Institute School of Public Health, George Washington University, Washington, DC, US

    Adnan Hyder

  6. Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston, TX, USA

    Miguel Cainzos-Achirica & Khurram Nasir

  7. Center for Computational Health and Precision Medicine, Houston Methodist, Houston, TX, USA

    Khurram Nasir

  8. Division of Health Equity and Disparities Research, Center for Outcomes Research, Houston, TX, USA

    Khurram Nasir

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  1. Zulqarnain Javed
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  1. Digital Health Innovation Laboratory, Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Johns Hopkins Hospital, Baltimore, MD, USA

    Seth S. Martin

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Javed, Z. et al. (2021). Social Determinants. In: Martin, S.S. (eds) Precision Medicine in Cardiovascular Disease Prevention. Springer, Cham. https://doi.org/10.1007/978-3-030-75055-8_1

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