An assessment of cardiovascular disease hospitalizations and disparities by race in patients with rheumatic disease hospitalizations in Alaska, 2015-2018

Abstract

Background: There is an increased risk of cardiovascular disease in people with many rheumatic diseases. The primary objective of this study was to evaluate cardiovascular disease hospitalizations in Alaska for people with and without a rheumatic disease diagnosis and assess disparities by race, with a focus on Alaska Native and American Indian people.

Methods: This study used the Alaska Health Facilities Data Reporting Program data on inpatient hospitalizations from 2015 to 2018. We identified people with a rheumatic disease diagnosis based on any hospitalization with a set of rheumatic disease diagnoses and compared them to people hospitalized but without a rheumatic disease diagnosis. We determined the odds of cardiovascular disease hospitalization by rheumatic disease diagnosis and assessed the influence of race and other factors, using univariate analyses and multivariable models.

Results: People with a rheumatic disease diagnosis other than osteoarthritis had higher odds of cardiovascular disease hospitalization. The odds ratio was highest in people with gout compared to other rheumatic diseases. In multivariable models, there was an interaction between race and rheumatic disease status. Specifically, having gout increased the odds of cardiovascular disease hospitalization for people of all races, while having a rheumatic disease other than gout or osteoarthritis increased the odds of cardiovascular disease hospitalization in Alaska Native/American Indian people but not in people of other races.

Conclusions: The association between rheumatic disease status and cardiovascular disease hospitalization in Alaska varied by type of rheumatic disease and race. This adds substantially to the literature on associations between rheumatic disease and cardiovascular disease in Indigenous North American populations.

Keywords: Cardiovascular Disease; Health Care disparities; Hospitalization; Rheumatic diseases.

Fig. 1

Percent of rheumatic disease patients with any cardiovascular disease hospitalization by rheumatic disease type and by race. This figure excludes spondyloarthritis, vasculitis, Sjögren syndrome, systemic sclerosis and myopathy because there were fewer than 50 people in each of these groups with a cardiovascular disease hospitalization. Comparisons by race were statistically significant (at p < 0.01) for all rheumatic disease types displayed except rheumatoid arthritis (p = 0.53) and SLE/MCTD (p = 0.71). Abbreviations: RD (rheumatic disease), OA (osteoarthritis), RA (rheumatoid arthritis), SLE/MCTD (systemic lupus erythematosus or mixed connective tissue disease), AN/AI (Alaska Native or American Indian)