Accuracy of Cardiovascular Risk Prediction Varies by Neighborhood Socioeconomic Position
Authors: Adam T. Perzynski, Michael B. Rothberg, Neal V. Dawson, Claudia J. Coulton, Jarrod E. Dalton
Journal: Annals of Internal Medicine (2018)

Letters1 May 2018Accuracy of Cardiovascular Risk Prediction Varies by Neighborhood Socioeconomic PositionAdam T. Perzynski, PhD, Michael B. Rothberg, MD, MPH, Neal V. Dawson, MD, Claudia J. Coulton, PhD, and Jarrod E. Dalton, PhDAdam T. Perzynski, PhDMetroHealth System, Cleveland, Ohio (A.T.P.)Search for more papers by this author, Michael B. Rothberg, MD, MPHCleveland Clinic, Cleveland, Ohio (M.B.R., J.E.D.)Search for more papers by this author, Neal V. Dawson, MDCase Western Reserve University, Cleveland, Ohio (N.V.D., C.J.C.)Search for more papers by this author, Claudia J. Coulton, PhDCase Western Reserve University, Cleveland, Ohio (N.V.D., C.J.C.)Search for more papers by this author, and Jarrod E. Dalton, PhDCleveland Clinic, Cleveland, Ohio (M.B.R., J.E.D.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L18-0008 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Spence provides an insightful comment on our finding that accepted standards for cardiovascular risk assessment underestimate risk for persons in disadvantaged neighborhoods. The explanation offered is that certain behavioral risk exposures (for example, passive smoking and unhealthy diet) are simply more common in disadvantaged neighborhoods, are difficult to accurately assess, and may be largely responsible for the discrepancy in observed versus estimated risk. We contend that the disparities observed in outcomes are too extreme to simply be the result of the distribution of such risk factors. If passive smoking were to explain the difference in observed versus ...References1. Phelan JC, Link BG, Tehranifar P. Social conditions as fundamental causes of health inequalities: theory, evidence, and policy implications. J Health Soc Behav. 2010;51 Suppl:S28-40. [PMID: 20943581] doi:10.1177/0022146510383498 CrossrefMedlineGoogle Scholar2. Du Y, Xu X, Chu M, Guo Y, Wang J. Air particulate matter and cardiovascular disease: the epidemiological, biomedical and clinical evidence. J Thorac Dis. 2016;8:E8-19. [PMID: 26904258] doi:10.3978/j.issn.2072-1439.2015.11.37 CrossrefMedlineGoogle Scholar3. Havranek EP, Mujahid MS, Barr DA, Blair IV, Cohen MS, Cruz-Flores S, et al; American Heart Association Council on Quality of Care and Outcomes Research, Council on Epidemiology and Prevention, Council on Cardiovascular and Stroke Nursing, Council on Lifestyle and Cardiometabolic Health, and Stroke Council. Social determinants of risk and outcomes for cardiovascular disease: a scientific statement from the American Heart Association. Circulation. 2015;132:873-98. [PMID: 26240271] doi:10.1161/CIR.0000000000000228 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: MetroHealth System, Cleveland, Ohio (A.T.P.)Cleveland Clinic, Cleveland, Ohio (M.B.R., J.E.D.)Case Western Reserve University, Cleveland, Ohio (N.V.D., C.J.C.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M16-2543. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAccuracy of Cardiovascular Risk Prediction Varies by Neighborhood Socioeconomic Position Jarrod E. Dalton , Adam T. Perzynski , David A. Zidar , Michael B. Rothberg , Claudia J. Coulton , Alex T. Milinovich , Douglas Einstadter , James K. Karichu , and Neal V. Dawson Accuracy of Cardiovascular Risk Prediction Varies by Neighborhood Socioeconomic Position J. David Spence Metrics Cited byNeighborhood and racial influences on triple negative breast cancer: evidence from Northeast Ohio 1 May 2018Volume 168, Issue 9Page: 681-682KeywordsCardiovascular diseasesDietDisclosureEnvironmental healthExerciseFoodMedical risk factorsMyocardial infarctionParticulatesRisk assessments ePublished: 1 May 2018 Issue Published: 1 May 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...