Racial Differences in FMD

BackgroundFibromuscular dysplasia (FMD) is a non-atherosclerotic arteriopathy associated with stenosis, aneurysm, and dissection. We aimed to characterize racial differences in clinical presentation and diagnosis among patients with FMD at our institution. MethodsWe utilized an ambulatory FMD database to review demographics, clinical presentation, and diagnostic assessments of patients diagnosed with FMD within a university-affiliated healthcare system. Patients were classified as White or Non-White based on self-identified race. We evaluated race-specific differences in diagnosis and disease manifestations. ResultsA total of 208 patients (White: n=160 (77%); Non-White; n=48 (23%)) were included in the analysis. The time from initial FMD symptom to diagnosis was longer in Non-Whites than Whites (5.5 vs. 1.5 yrs; p<0.001), yet time from diagnosis to Emory specialist center visit was longer in Whites (3.2 vs. 1.2 yrs; p=0.035). Whites were more likely to undergo [&ge;] 5 multi-imaging diagnostic assessments than Non-Whites (89% vs. 73%; p=0.002). History of hypertension, stroke, & chronic kidney disease were more common in Non-Whites. FMD involvement of the internal carotid artery and upper extremity vessels were more common in Non-Whites, while Whites had more renal artery involvement. ConclusionWe found racial differences in the diagnosis of FMD. The time from symptom onset to diagnosis was longer in Non-White than White FMD patients. Multimodality diagnostic imaging was more often utilized in Whites than Non-Whites. Research is needed to investigate these racial differences.