Heart attack outcomes worse for blacks than whites due in part to individual characteristics

Black heart attack patients have worse outcomes than their white counterparts in large part because of preexisting chronic health conditions and socioeconomic factors, according to a study published in the March issue of Annals of Internal Medicine, Reuters Health reports.

For the study, author John Spertus of the Mid America Heart Institute and colleagues analyzed data from a registry of 1,849 heart attack survivors, 28% of whom were black.

According to researchers, 19.9% of black patients died within two years of a heart attack, compared with 9.3% for whites. Blacks also had higher rates of severe chest pain at 28%, compared with 17.8% among whites, and had lower quality of life scores. Blacks also were less likely than whites to undergo a procedure to unblock clogged coronary arteries.

There were no differences in genetics or treatment, and most of the disparities can be attributed to "patient characteristics present before admission," according to the study. Black patients had significantly higher rates of diabetes, high blood pressure, and chronic heart and kidney failure. They also had lower health insurance coverage rates, lower incomes and were less likely to be married. According to researchers, there was some indication that hospital quality partly contributed to the disparities, but "no single omission in the care offered [to] black patients would, if overcome, eradicate the crude differences in observed outcomes" (Reuters Health, 3/2).

An abstract of the study is available online.