EMBARGOED by JAMA Cardiology until December 7, 2022, 11 a.m., ET
Contact: Gina DiGravio, 617-358-7838, ginad@bu.edu
(Boston)—Social determinants of health (SDOH) are the influence of circumstances and systems in which individuals are born, live, work, age and access health care. The deleterious consequences of SDOH on atrial fibrillation (AF) have rarely been investigated.
To address this oversight, the National Heart, Lung, and Blood Institute convened an expert panel to identify major knowledge gaps and research opportunities in the field of social determinants of AF. Led by Boston University Chobanian & Avedisian School of Medicine researcher Emelia Benjamin, MD, ScM, the panel identified multiple knowledge gaps and research opportunities to accelerate SDOH research related to AF.
“Social determinants of health affect access to care and management decisions for AF, increasing the likelihood of adverse outcomes among individuals who experience systematic disadvantages,” says corresponding author Benjamin, professor of medicine.
AF is an irregular, often rapid heartbeat (arrhythmia) that can result in blood clots in the heart and increases the risk of stroke, heart failure and other complications
The panel addressed the following social determinants:
- Socioeconomic status and access to health care
- Health literacy
- Race, ethnicity and racism
- Sex and gender
- Shared decision making in disadvantaged populations
- Place, including rurality, neighborhood and community
Multiple social determinants could be factored into the impact of AF on the health of individuals and communities. Additionally, cumulative disadvantages that accumulate throughout one’s lifetime and have been associated with cardiovascular mortality in women, have not been studied regarding impacts on AF.
The researchers submit that the development of advanced statistical and machine learning approaches may allow for analyses of complex intersectional identities. “Ensuring equitable access to broadband and mobile health technologies will enhance research in technologically disadvantaged populations,” adds Benjamin, who also is a cardiologist at Boston Medical Center.
These findings appear as a Special Communication in JAMA Cardiology.
Dr. Benjamin is funded by NIH, NHLBI R01HL092577; American Heart Association AF AHA_18SFRN34110082
Note to Editor:
No disclosures relevant to manuscript: Drs: Benjamin, Alonso, Chamberlain, Cooper, Desvigne-Nickens, Essien, Kershaw, Magnani, Matlock, Soliman; Ms. Hills. Dr. Thomas reports serving as a consultant for Biosense Webster, Pfizer, Bristol Myers Squibb, Johnson & Johnson, Advisory Council for NHLBI, Steering Committee for REACT AF (Rhythm Evaluation for Anticoagulation with Continuous monitoring of Atrial Fibrillation). Dr. Go is a member of the Operations Committee and Steering Committee for the GUARD-AF Study (A Study to Determine if Identification of Undiagnosed Atrial Fibrillation in People at Least 70 Years of Age Reduces the Risk of Stroke; NCT04126486) sponsored by Bristol Meyers Squibb and Pfizer. Dr. Go has also received research funding through his institution from Bristol Meyers Squibb; iRhythm Technologies; and Janssen Research and Development. Dr. Albert is a member of the Data Safety and Monitoring Board for the Apple Watch Study and is on the Steering Committee for the CHANGE AF study. Dr. Hernandez reports serving as a Consultant to Pfizer, Bristol Myers Squibb
Dr. Levy is Immediate Past Chair, Accreditation Oversight Committee and current member of the National Cardiovascular Data Registry Oversight Committee, American College of Cardiology; President, Southeast Michigan American Heart Association. Dr. O'Brien reports research grants to her institution from Pfizer, Bristol Myers Squibb, and Novartis. Dr. Russo has received research support (Boston Scientific, Medilynx); Consultant/Advisory Board (Biosense Webster, Boston Scientific, Medtronic); Research Steering Committee (Apple Heart Study, Boston Scientific, Medtronic)Dr. Rodriguez has received honoraria from Merck and research support from and participated on an Advisory Board for Amgen. Dr. Al-Khatib has received research funding from Medtronic, Boston Scientific, and Abbott.
Journal
JAMA Cardiology
Method of Research
Data/statistical analysis
Subject of Research
Not applicable
Article Title
Transforming Atrial Fibrillation Research to Integrate Social Determinants of Health: A National Heart, Lung, and Blood Institute Workshop Report
Article Publication Date
7-Dec-2022
COI Statement
No disclosures relevant to manuscript: Drs: Benjamin, Alonso, Chamberlain, Cooper, Desvigne-Nickens, Essien, Kershaw, Magnani, Matlock, Soliman; Ms. Hills. Dr. Thomas reports serving as a consultant for Biosense Webster, Pfizer, Bristol Myers Squibb, Johnson & Johnson, Advisory Council for NHLBI, Steering Committee for REACT AF (Rhythm Evaluation for Anticoagulation with Continuous monitoring of Atrial Fibrillation). Dr. Go is a member of the Operations Committee and Steering Committee for the GUARD-AF Study (A Study to Determine if Identification of Undiagnosed Atrial Fibrillation in People at Least 70 Years of Age Reduces the Risk of Stroke; NCT04126486) sponsored by Bristol Meyers Squibb and Pfizer. Dr. Go has also received research funding through his institution from Bristol Meyers Squibb; iRhythm Technologies; and Janssen Research and Development. Dr. Albert is a member of the Data Safety and Monitoring Board for the Apple Watch Study and is on the Steering Committee for the CHANGE AF study. Dr. Hernandez reports serving as a Consultant to Pfizer, Bristol Myers Squibb Dr. Levy is Immediate Past Chair, Accreditation Oversight Committee and current member of the National Cardiovascular Data Registry Oversight Committee, American College of Cardiology; President, Southeast Michigan American Heart Association. Dr. O'Brien reports research grants to her institution from Pfizer, Bristol Myers Squibb, and Novartis. Dr. Russo has received research support (Boston Scientific, Medilynx); Consultant/Advisory Board (Biosense Webster, Boston Scientific, Medtronic); Research Steering Committee (Apple Heart Study, Boston Scientific, Medtronic)Dr. Rodriguez has received honoraria from Merck and research support from and participated on an Advisory Board for Amgen. Dr. Al-Khatib has received research funding from Medtronic, Boston Scientific, and Abbott.