Blacks Get Less Aggressive Heart Attack Care

Racial Disparities in Heart Attack Care Still Persist, Study Says

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March 3, 2005 - Blacks are still less likely than whites and Hispanics to receive aggressive treatment after a heart attack, according to a new study.

Researchers say racial differences in surgical heart attack treatment such as bypass were first documented in the 1980s, but the results of their study suggest that although the gap has narrowed in recent years, disparities still persist.

The study showed that only five in 10 blacks compared with nearly six in 10 whites and Hispanics received a procedure known as cardiac catheterization, which allows doctors to evaluate blood flow to the heart and assess the scope of heart disease and heart artery blockage before determining the appropriate treatment.

Cardiac catheterization involves inserting a thin flexible tube (catheter) through a blood vessel in the arm or groin to the heart. Dye is then injected to trace the movement of blood in the heart and surrounding arteries.

"Heart disease is a leading cause of illness and death in our country that disproportionately affects African-Americans," says researcher Alain G. Bertoni, MD, MPH, assistant professor of medicine at Wake Forest Baptist Medical Center, in a news release. "There is still work to be done to understand why this disparity exists."

Disparities in Heart Care Persist

In the study, which appears in the March issue of Journal of the National Medical Association, researchers compared the rates of cardiac catheterization in about 585,000 white, 51,000 black, and 32,000 Hispanic people treated for heart attack in U.S. hospitals from 1995-2001.

Researchers found cardiac catheterization rates were higher for whites than blacks for all years examined, while rates among Hispanics approached that of whites during the study period.

Overall, 58% of whites received the cardiac catheterization as part of their heart attack treatment, compared with 50% of blacks and 55% of Hispanics.

"Severity of illnesses, patient and physician preferences may play some role, but there are no conclusive reasons for the disparity," says Bertoni. "If African-American patients are more informed, they can have improved dialogue with the medical team deciding how to care for them."

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SOURCES: Bertoni, A. Journal of the National Medical Association, March 2005; vol 97: pp 317-323. News release, Wake Forest University Baptist Medical Center.
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