{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T12:29:57Z","timestamp":1794054597952,"version":"4.8.0"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"23","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">The risk for atherosclerotic cardiovascular disease (ASCVD) events may differ by sociodemographic factors among patients meeting the definition of very high risk according to the 2018 American Heart Association\/American College of Cardiology cholesterol guideline, leading to treatment disparities. We estimated the risk for recurrent ASCVD events among adults meeting the definition of very high risk by age, sex, race\/ethnicity, and socioeconomic status in a US integrated healthcare system.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">The study cohort included Kaiser Permanente Southern California members aged \u226521\u00a0years with a history of clinical ASCVD on September 30, 2009. Very high risk for recurrent ASCVD was defined by a history of \u22652 major ASCVD events or a history of 1 major event along with \u22652 high\u2010risk conditions. Patients were followed through 2015 for a first recurrent ASCVD event. Of 77\u00a0101 patients with ASCVD, 50.8% met the definition for very high risk. Among patients meeting the definition of very high risk, recurrent ASCVD rates were higher in older (&gt;75\u00a0years) versus younger patients (21\u201340\u00a0years) (sex\u2010adjusted hazard ratio [HR] [95% CI] 1.85; 1.23\u20132.79), non\u2010Hispanic Black patients versus non\u2010Hispanic White patients (age\u2010, sex\u2010adjusted HR, 1.32; 1.23\u20131.41), those who lived in neighborhoods with lower (&lt;$35k) versus higher annual household income (\u2265$80k) (HR, 1.20; 1.11\u20131.30), or with lower (\u226531.2%) versus higher education levels (&lt;8.8% high school or lower) (HR, 1.26; 1.19\u20131.34).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Disparities in the risk for recurrent ASCVD events were present across sociodemographic factors among very high risk patients. The addition of sociodemographic factors to current definitions of very high risk could reduce health disparities.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.017310","type":"journal-article","created":{"date-parts":[[2020,11,23]],"date-time":"2020-11-23T10:09:43Z","timestamp":1606126183000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":26,"title":["Recurrent Atherosclerotic Cardiovascular Event Rates Differ Among Patients Meeting the Very High Risk Definition According to Age, Sex, Race\/Ethnicity, and Socioeconomic Status"],"prefix":"10.1161","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3161-5732","authenticated-orcid":false,"given":"Jaejin","family":"An","sequence":"first","affiliation":[{"name":"Kaiser Permanente Southern California Pasadena CA"},{"name":"Kaiser Permanente School of Medicine Pasadena CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiyi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Division of General Medicine Columbia University Medical Center New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4711-5492","authenticated-orcid":false,"given":"Paul","family":"Muntner","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham AL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew E.","family":"Moran","sequence":"additional","affiliation":[{"name":"Division of General Medicine Columbia University Medical Center New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin\u2010Wen","family":"Hsu","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Southern California Pasadena CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7619-1649","authenticated-orcid":false,"given":"Kristi","family":"Reynolds","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Southern California Pasadena CA"},{"name":"Kaiser Permanente School of Medicine Pasadena CA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000625"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.09.025"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000659"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.27.2.350"},{"key":"e_1_3_1_6_2","volume-title":"Health, United States, 2011: With Special Feature on Socioeconomic Status and Health","author":"National Center for Health Statistics (US)","year":"2012","unstructured":"National Center for Health Statistics (US) . 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