title: Disparities in cardiovascular disease among Caribbean populations: a systematic literature review.
abstract: BACKGROUND
  Cardiovascular diseases (CVD) are the predominant cause of death globally. The large health disparities in the distribution of the burden of disease seen in developed and developing countries are of growing concern. Central to this concern is the poor outcome which is seen disproportionately in socially disadvantaged groups and racial/ethnic minorities. The aim of the study was to conduct a systematic literature review to investigate the nature of cardiovascular disease health disparities among Afro-Caribbean origin populations and identify current knowledge gaps.
  
  
  METHODS
  A systematic literature review including a detailed search strategy was developed to search MEDLINE and other research databases. Using an a priori protocol peer-reviewed publications and grey literature articles were retrieved and screened and relevant data extracted by two independent review authors. Thematic analysis was done according to CVD outcomes and measures of disparity including age, sex, ethnicity and socioeconomic status.
  
  
  RESULTS
  The search retrieved 665 articles of which 22 met the inclusion criteria. Most studies were conducted in the United Kingdom and centered on the prevalence of CVD by ethnicity, age and sex. An important sub-theme identified was the disparities in health service utilization/hospital admission. Coronary Heart Disease (CHD) and Peripheral Arterial Disease (PAD) were less prevalent among Afro-Caribbeans compared to Caucasian and South East Asian ethnic groups. The prevalence of CHD ranged from 0-7% in Afro-Caribbean to 2-22% in Caucasians. Strokes were more common among Afro-Caribbeans. There are inadequate data on morbidity and mortality from CVD, particularly across the socio-economic gradient, in Afro-Caribbean populations.
  
  
  CONCLUSIONS
  There are important differences in morbidity and mortality from CVD across ethnic groups. Important knowledge gaps remain in understanding the social determinants of these disparities in CVD. More research exploring these gaps by varying disparity indicators needs to be undertaken.
authors: Epidemiology Research Unit, Tropical Medicine Research Institute, The University of the West Indies, Kingston, West Indies, Jamaica. damian.francis@uwimona.edu.jm.
authors: Damian K
authors: DK
authors: Francis
authors: Epidemiology Research Unit, Tropical Medicine Research Institute, The University of the West Indies, Kingston, West Indies, Jamaica. nadia.bennett@uwimona.edu.jm.
authors: Nadia R
authors: NR
authors: Bennett
authors: Epidemiology Research Unit, Tropical Medicine Research Institute, The University of the West Indies, Kingston, West Indies, Jamaica. trevor.ferguson02@uwimona.edu.jm.
authors: Trevor S
authors: TS
authors: Ferguson
authors: Chronic Disease Research Centre, Tropical Medicine Research Institute, The University of the West Indies, Bridgetown, West Indies, Barbados. ahennis1@gmail.com.
authors: Anselm J M
authors: AJ
authors: Hennis
authors: Epidemiology Research Unit, Tropical Medicine Research Institute, The University of the West Indies, Kingston, West Indies, Jamaica. rainford.wilks@uwimona.edu.jm.
authors: Rainford J
authors: RJ
authors: Wilks
authors: The University of the West Indies, Kingston, West Indies, Jamaica. enigel.harris@uwimona.edu.jm.
authors: E Nigel
authors: EN
authors: Harris
authors: Department of Medical Education, Morehouse School of Medicine, Atlanta, USA. mmacleish@msm.edu.
authors: Marlene M Y
authors: MM
authors: MacLeish
authors: The Sullivan Alliance, Alexandria, USA. sullivan@pemsm.com.
authors: Louis W
authors: LW
authors: Sullivan
mesh_terms: D044466:Asian People / Q000706:statistics & numerical data; D044383:Black People / Q000706:statistics & numerical data; D002318:Cardiovascular Diseases / Q000208:ethnology*; D017691:Caribbean Region / Q000453:epidemiology; D003327:Coronary Disease / Q000208:ethnology; D005006:Ethnicity / Q000706:statistics & numerical data*; D054624:Health Status Disparities; D006801:Humans; D015995:Prevalence; D044469:Racial Groups / Q000706:statistics & numerical data*; D044465:White People / Q000706:statistics & numerical data