Researchers and clinicians have made astonishing strides in cardiovascular disease prevention, diagnosis, and treatment. The tremendous progress throws into stark contrast the disturbing persistence of disparities in cardiovascular disease risk factors, treatment, and outcome by ethnicity, race, socioeconomic conditions, and region. The causes of ethnic and racial disparities in cardiovascular disease are highly complex and incompletely understood. The American Heart Association and the Editorial Board of Circulation seek to encourage research and practice to reveal the causes, consequences, and effective initiatives to diminish ethnic and racial disparities in health care.
The present issue of Circulation includes the Executive Summary of the American Heart Association’s National Conference “Discovering the Full Spectrum of Cardiovascular Disease: The Minority Health Summit 2003.” In addition, the issue features editorials and commentaries by thought leaders on approaches to eradicating ethnic and racial disparities in cardiovascular disease. The Editorial Board of Circulation solicited and is featuring original research that addresses ethnic and racial disparities. The original research provides valuable insights into ethnic and racial disparities in a wide range of cardiovascular disease fields, including: Epidemiology and health outcomes; subclinical disease (coronary artery calcification); clinical (coronary heart disease, valvular heart disease, heart failure, hypertension, and stroke) and interventional cardiology; surgery; pediatric cardiology; and international health. In addition, the issue includes a report by Becker and colleagues on a novel, effective, community-based intervention to prevent cardiovascular disease in high-risk American black families. The breadth and quality of submissions engenders cautious optimism that clinical, research, nonprofit, and government partners can effectively diminish ethnic and racial disparities in cardiovascular disease.
During the production of this themed issue, the question of terminology used to define racial/ethnic groups created considerable discussion among those associated with the Journal and this special content. For a discussion of the complexities of the issue, we refer you to the publication by Kaplan and Bennett (Kaplan JOB, Bennett T. Use of race and ethnicity in biomedical publication. JAMA. 2003;289:2709–2716). We sought to use terminology that was accurate in describing the populations studied and discussed while remaining sensitive to the historical and current use of language and its ability to create stereotypes and stigma. This effort was overlaid on the existing Journal style for Circulation. As an international journal, Circulation uses, with exceptions, the terms “blacks” and “whites” in describing differing racial/ethnic groups. We hope that the use of this imperfect compromise does not detract from the science and will be viewed by the readership as an accurate and unbiased attempt to describe the disparities in cardiovascular healthcare.