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Heart Biases That Can Kill

Millions of Americans experience heart attack symptoms each year. So why do some get better treatment than others?

Unconscious Prejudice?

Still, doctors get their share of blame, says Curry, who served as Howard's chief of cardiology and in 1999 was named the American Heart Association's "Physician of the Year."

"I think there is probably a bit of unconscious prejudice going on that may explain why there's a better level of care given by doctors if you're white, male, and well-incomed than if you're a minority, female, or poor," he tells WebMD.

He cites one event two decades ago when the 70-year-old mother of one his staff members developed heart disease. "After learning about her condition, it was my estimation that she needed a pacemaker," says Curry.

But the woman wasn't getting one from her doctor. "The reason I was given by her doctor was that she was old and didn't have long to live. We talked about it and she did get her pacemaker. That was 20 years ago, and she's still living. But I believe because she was an old black woman, she would have died if I hadn't intervened and the doctor had used his normal instinct. I think if she were white she would have gotten the pacemaker sooner."

That "instinct" may result from past medical training, he says.

"There was a time when physicians were taught in medical school that blacks do not usually have heart attacks, so some of these treatment inequities may be a holdover from that," Curry tells WebMD. "Of course, they don't teach that anymore, since it's the most common cause of death among African Americans."

Wealth Allows Heart-Healthy Lifestyle

Doctors may also believe that poorer people are less likely -- or even able -- to follow a lifestyle that can prevent heart attacks.

"If you go 10 blocks south of my hospital, you're in one of the wealthiest neighborhoods in the U.S., but if you go 10 blocks north, you're in one of the poorest," says cardiologist Ira Nash, MD, of Mount Sinai School of Medicine in New York City and a spokesman for the American Heart Association.

"The difference of food available is those two neighborhoods is striking. You cannot find fresh foods or even fresh milk in the poor neighborhood, which is populated primarily by minorities. All there is available is fast food and prepackaged, highly processed carbs," he says. "When people talk about the role of stress in heart disease, many think of the high-pressured executive. I think it's a lot more stressful to be a welfare mother."

That may explain what Curry has seen in his own hospital.

"I've never known a doctor who met a poor man and would say, 'I'm not going to do all I can do to save his life,'" he says. "But in my hospital, we treat everyone from congressmen to homeless people, and I have seen that some doctors do not spend as much time with that homeless man as they would with a congressman."

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