Abstract P304: Underuse of Cardiovascular Medications in Individuals With Lower Extremity Peripheral Artery Disease: the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)
Bibliographic record
Abstract
Introduction: The underuse of cardiovascular therapies among individuals with lower extremity peripheral artery disease (PAD) has been reported. However, little is known about this in the Hispanic/Latinos, who may have limited access to health care and worse clinical outcomes than non-Hispanics. Methods: We studied the cross-sectional use of cardiovascular therapies including antiplatelet, lipid-lowering and antihypertensive medications among 826 HCHS/SOL participants who reported a PAD diagnosis by a physician. We studied the factors that may be associated with use of cardiovascular medications, including demographic, socioeconomic factors, acculturation, access to health care and comorbidities. Survey Poisson regression was used to generate the prevalence ratios. Factors in age-adjusted models with P≤0.10 were included in multivariate regression. Results: A total of 723 participants with medical history of PAD were free of coronary heart disease (CHD, mean age=53) while 103 patients had concurrent CHD (mean age=56). The overall age-adjusted prevalence of antiplatelet, lipid-lowering and antihypertensive medications were 31%, 26% and 34%, respectively. Individuals of Mexican background had low health insurance coverage (42%) and low use of antiplatelet (20%), statin (17%) and antihypertensive (47% among hypertensive individuals) medications. More advanced age, number of doctor visits (2+ vs 0-1) in the past year and number of cardiovascular risk factors (2+ vs 0-1) were significantly associated with using cardiovascular medications in adjusted models. Compared with those with PAD alone, individuals with PAD and concurrent CHD were more likely to use antiplatelet (PR=1.44, 95% CI 1.13-1.82) and statin (PR=1.56 [1.17-2.07]) treatment in the multivariate analysis. Conclusions: We found underuse of cardiovascular medications among Hispanic/Latino individuals with medical history of PAD. More efforts should be directed in eliminating treatment disparities in this important race-ethnic group.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".