November 13, 2006

Higher Death Rate Seen for Black U.S. Heart Patients
(Reuters Health)

Black heart disease patients died at a much higher rate than equally sick white patients, researchers said on Sunday in the latest U.S. study showing racial disparity in disease survival.

Researchers speculated racial discrimination by doctors may have played a role, perhaps in the types of treatment given to white and black patients, but that is hard to prove.

The study involved data on 21,000 heart patients treated at Duke University medical facilities in Durham, North Carolina, between 1986 and 2004. More than 3,000 of the patients were black.

It found that among those diagnosed with serious coronary disease, black patients had a 36 percent survival rate and white patients a 46 percent survival rate. The patients were tracked for an average of nine years.

"We saw that there were significant differences in survival," said Duke cardiology fellow Dr. Kevin Thomas, who reported the results at an American Heart Association meeting in Chicago.

"Physician bias may play a part in it. That's a very hard thing to get at," Thomas added.

Thomas noted that black patients in the study had more risk factors for worse survival rates than the white patients, including higher rates of diabetes, high blood pressure and kidney disease.

But the black patients also tended to be about a decade younger than the white patients, and younger age normally is associated with better medical outcomes in these cases, Thomas said.

Even when the researchers statistically accounted for those patient characteristics, the higher death rates for the black patients persisted, meaning other factors contributed to the disparity.

Researchers found little difference in the extent of coronary disease between blacks and whites. But they found that whites were 12 percent more likely to receive coronary bypass surgery than blacks within 30 days of cardiac catheterization, the initial diagnostic study.

Asked why this was the case, Thomas said, "Well, that's the million dollar question."

The study reinforced and amplified on previous research finding racial disparities in U.S. disease survival and types of treatment given to patients.

Coronary artery disease, in which the arteries supplying blood to the heart become hardened and narrowed, is the most common type of heart disease and the leading cause of death in the United States in both men and women.

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