JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY

VOL. 64, NO. 4, 2014

ª 2014 BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION

ISSN 0735-1097/$36.00

PUBLISHED BY ELSEVIER INC.

http://dx.doi.org/10.1016/j.jacc.2014.05.019

EDITORIAL COMMENT

Targeting Priority Populations to Reduce Disparities in Cardiovascular Care Health Equity for All* Leslee J. Shaw, PHD, Javed Butler, MD, MPH

T

he evolving care paradigm and ensuing

mortality remains for women. Across each of the 10-

implementation of high-quality evidence

year spans observed, higher in-hospital mortality

that defines optimal benefits and risks into

rates were reported among women compared with

daily clinical practice has resulted in dramatic de-

men. Attributing factors for excess deaths leading to

clines in case fatality rates for cardiovascular disease

suboptimal care for women are complex and vary

over the past several decades. Since the late 1970s,

from sex-specific differences in plaque rupture and

age-adjusted coronary heart disease mortality rates

erosion to socioeconomic factors and reduced diag-

have been halved in the United States (1). In this issue

nostic accuracy (5). The recent focus on the imple-

of the Journal, recent data from the Nationwide Inpa-

mentation of guideline-recommended best practices and appropriate use criteria is one means to advance

SEE PAGE 337

sex equity in post–myocardial infarction care. How-

tient Sample reveal trends in acute myocardial infarction (AMI) hospitalization and mortality rates among younger adults (