Local health study goes to heart of the matter

The heart health of Tarrant County residents is under investigation as the Primary Care Research Institute, at the UNT Health Science Center, continues in its North Texas Healthy Heart Study. Preliminary results of the study were published in December 2008 in a research brief, but researchers involved in the study hope it can turn into a long-term endeavor to untangle the many complicated relationships between ethnicity and heart health.

The study, which started with pilot work performed in 2005 and has had financial backing through the National Institutes of Health, is in the middle of examining follow-up data gathered from 571 residents of varying racial backgrounds in order to take a local look at varying risk factors for coronary artery calcification — an indicator of heart health — for different ethnic groups.

Those who participate in the study are providing a range of data that focuses directly on cardiovascular health as well as other information that could be related to heart health disparities among different races.

The study at this point is purely observational, said Dr. Roberto Cardarelli, the principal investigator in the study and executive director and founder of the Primary Care Research Institute. In 2005 and 2006, study participants were recruited and took part in the data gathering, and in 2008 participants were contacted again for follow-up information. Heart health is something that can change slowly or quickly (think long-term calcification or a sudden heart attack), and even though there is a large group of participants, at this point itÂ’s difficult to draw definitive conclusions from the study, Cardarelli said.

“We realize, ‘Is two years enough to see a change?’” Cardarelli said.

Because the study is gathering so much varied data from so many people, there will be a large pool of data to draw upon later and look for any relationships, said Joan Carroll, assistant professor in the department of integrative physiology and part of the study team.

“We have all sorts of things and we can throw it into a computer,” she said.

There have been some analyses done on the data already, and there are some variations that already have been pinpointed to warrant further research. For example, social support can impact levels of coronary artery calcification — emotional support was protective against calcification in whites, but in Hispanics and blacks, a high amount of emotional support was a risk factor for calcification. Additionally, those who said they’d experienced racial discrimination but didn’t do anything about it were nine times more likely to have elevated calcification levels than those who didn’t experience discrimination.

The field of cardiology has been aware of racial and ethnic disparities for some time, said Dr. Vinit Lal, medical director of cardiology and co-chair of the Chest Pain Center at Texas Health Arlington Memorial Hospital. The center recently earned a Cycle III accreditation from the Society of Chest Pain Centers — the highest accreditation possible for chest pain treatment — and Lal said that any time a patient comes in, his or her race is considered a piece of information that can be useful to help with diagnosis or treatment. It’s viewed as part of a patient’s history and physical, he said.

“I remember probably a good 80 to 90 studies have been done in the past looking at racial and ethnic disparities, especially in cardiac diseases,” Lal said.

While the majority of studies have focused on differences between whites and blacks, Lal said more studies are including Hispanic and Asian populations as well. While there are many reasons that care can vary according to a personÂ’s race, Lal said hasnÂ’t yet seen a large study that can definitively pinpoint reasons for disparities.

“Hopefully over the next five, 10 years, all of this will disappear,” he said.

Kathryn Cardarelli, assistant professor of epidemiology at the Health Science Center and another part of the Healthy Hearts study team, said if the study continues to get funding to stretch its observations further into the future, the results would be more comprehensive and more valuable when disseminated to local health care professionals.

“The more potentially impactful findings have yet to come,” she said.