Past Discrimination Tied to Worse Recovery After Heart Attack

3 min read

Nov. 28, 2022 – About one in three adults who survived a heart attack at a relatively young age say they have experienced discrimination, and the findings of a new study also showed that the experience was tied to worse recovery in the months afterward. 

The discrimination or unfair treatment in everyday life was based on their race, gender, low family income, or other reasons.

People who experienced discrimination were more likely to have chest pain (angina) and report worse quality of life both 1 month and 1 year after they were hospitalized for a heart attack. 

Andrew J. Arakaki, a PhD candidate at Yale School of Public Health in New Haven, CT, presented these study findings at a recent American Heart Association conference.

"It is important to acknowledge that patients cannot control the discriminatory actions of others in everyday life," he said. "Social support from family, friends, or peers who are in a similar situation" may help young heart attack survivors cope with stress caused by discrimination, he suggested. 

More research is needed "to understand how to support patients with high levels of perceived discrimination during heart attack recovery" and to see which ways to cope with the problem may help reduce stress. 

For the study, the researchers looked at data from 2,670 adults who were 18 to 55 years old when they had a heart attack, and who took part in the Variation in Recovery: Role of Gender on Outcomes (VIRGO) study.

The patients replied to three questionnaires while in the hospital, and then 1 month and 12 months later.

About 35% said that they experienced discrimination in their daily lives rarely, sometimes, or often, with the remainder reporting they never experienced it. "We were surprised to discover how common perceived discrimination was among participants in our study sample," Arakaki said in a news release. 

These results agree with the results of many other studies that link psychological stress with poor outcomes in heart patients, says Viola Vaccarino MD, PhD, who was not involved with this research.

Vaccarino, a professor and chair of the Department of Epidemiology at Emory University in Atlanta, led a related study among others. 

For young adults who have had a heart attack, she says, "It is important for you to reduce your stress. This is something to discuss with your doctor, and, if indicated, see if he or she can refer you to a counsellor or advise you on ways to counteract the stress in your life."

In the current study, two-thirds of the patients were women, and most (76%) were white. They were asked to indicate the main source of the discrimination they experienced, if any, based on race, ethnicity, gender, age, income, language, physical appearance, sexual orientation, or other. 

In the "other" category, patients reported perceived discrimination based on their occupation, education level, medical history or disability, or personal history (divorce, previous incarceration, past abuse, or drug use).

The patients replied to a 10-question Everyday Discrimination Scale, which has been used in other studies

They were asked to answer "Never," "Rarely," "Sometimes," or "Often" to each of the following questions:

"In your day-to-day life, how often do any of the following things happen to you? 

1.You are treated with less courtesy than other people are.

2. You are treated with less respect than other people are.

3. You receive poorer service than other people at restaurants or stores.

4. People act as if they think you are not smart.

5. People act as if they are afraid of you.

6. People act as if they think you are dishonest.

7. People act as if they’re better than you are.

8. You are called names or insulted.

9. You are threatened or harassed.

10. People ignore you or act as if you aren’t there."

The responses were scored as never (0 points), rarely (1), sometimes (2), and often (3) for each item, giving a total of 0 to 30.

The higher the experience of discrimination, the worse recovery appeared to be.