A Carle Illinois College of Medicine student is championing new research that reveals how heart disease affects diverse populations, including its growing incidence among young people. The long-term goal is to use the data in developing precision medicine tools that will allow clinicians to tailor prevention and treatment to each patient’s risk factors and profile.
Atherosclerotic cardiovascular disease (ASCVD) is caused by a buildup of plaque in the arteries. Scientists already know a lot about clinical risk factors for this form of coronary artery disease and stroke, which include diabetes, obesity, high blood pressure, and high cholesterol. However, because certain demographic groups have historically been underrepresented in medical research, they know much less about the social drivers that affect those populations.
To find answers, CI MED student Maaz Imam and a team of researchers from the Stanford University School of Medicine’s Cardiovascular Institute tapped into the National Institutes of Health All of Us database. This tool is unique in part because of its size (more than 450,000 electronic health records) and its diversity, including more women than men and data from a sizable portion of patients who are not white.
The team found an increased incidence of cardiovascular disease in certain populations that have previously been under-studied. “Several underrepresented groups including adults identifying as ‘other’ ethnicity, adults identifying as ‘other’ gender, as well as social determinants of health such as lower annual incomes, lower educational attainment, and higher deprivation levels, were more likely to have prevalent ASCVD among this All of Us cohort,” Imam said.
A second study by members of the same research group examines the rise in heart disease caused by atherosclerosis in younger populations (age under 50). They found that several traditionally underrepresented groups including those of Black ethnicity, low annual income (less than $25,000), and an education level lower than a college degree were associated with ASCVD at a young age.
The findings set the stage for future work to capture why these populations are impacted more than others. “The next step from here would be to leverage genomic data and wearable data to better understand what the most apparent risk factors are,” Imam said.
Precision medicine – which blends precise data insights with studying the health of large populations – holds great promise in helping to promote health equity across all demographics, Imam said. “As we continue to refine this approach and knowledgebase, we can begin to leverage artificial intelligence to assist us in developing risk assessment algorithms and tools with high clinical utility. Imagine if you had a digital twin that your provider could ‘treat’ through their local machine before administering a treatment directly to you.”
In addition to his research with the Stanford HEART lab, Imam is working to help other students and faculty members at CI MED gain open access to and use the All of Us workbench for their research. He believes future work could advance high-quality personalized medicine research at CI MED and advance understanding of disease patterns in a broader, diverse patient population.
“The goal of the All of Us Research Program is to help transform the future of health research by equipping researchers with expansive health data from diverse populations. As the world’s first engineering-based medical school, Carle Illinois College of Medicine (CI MED) is an ideal setting to use All of Us data to improve understanding of health and disease, identify opportunities to reduce disparities, and enable more precise approaches to care,” said Rubin Baskir, the branch director for research, engagement, and outreach with the NIH All of Us research program.
Imam presented the findings on atherosclerosis in diverse populations at the American Society for Preventive Cardiology's 2024 Conference in Salt Lake City, Utah earlier this year. His abstract in the American Journal of Preventive Cardiology can be found here.
Editor’s note: The work detailing ASCVD in younger populations is available here. Imam is a co-author on this work with Dr. Sara King of Stanford.