Blacks at greater risk of dying from heart attacks than whites, says study

August 26, 1993|By Chicago Tribune

Blacks are more likely to suffer cardiac arrest and die than whites and are less likely to get intensive treatment for heart disease, said two studies published in today's New England Journal of Medicine.

"In general, blacks were two to three times as likely to have a cardiac arrest and . . . about three times as likely to die" from it, said Lance Becker, assistant professor of medicine at the University of Chicago who led a study involving 6,451 patients who suffered cardiac arrests outside of a hospital.

The researchers found the emergency medical response was similar for patients of both races. "I believe our emergency medical service is basically colorblind," he said.

However, blacks had more unwitnessed cardiac arrests and were less likely to receive CPR from bystanders. This added to the time lag before medical help arrived. "We're just not able to be there fast enough," Dr. Becker said.

"There may be some basis in racial bias to this," he said. "Do blacks have the same ease of access to the telephone? Do we inform the black community about the risks? About the warning signs? I think we could do better."

Even among patients who survived long enough to be admitted to a hospital, only 13 percent of black patients survived, whereas 25 percent of white patients did.

"We think there will be multiple reasons why blacks do worse than whites, such as factors related to socioeconomic differences and health care. There's probably a genetic factor, too," Dr. Becker said.

Another study, by the Pittsburgh Veteran Affairs hospital system, showed that blacks were less likely to receive common invasive methods for diagnosing and treating heart problems.

The study, led by Jeff Whittle, examined the medical records of 428,300 men admitted to VA hospitals across the nation.

Studies of the private sector have shown similar differences in treatment, he said. This has led some to argue that financial inequalities, like better insurance coverage, may have been the reason for the differences.

"But at VA hospitals, care is equally accessible to everyone," Dr. Whittle said.

Whites were twice as likely to receive bypass surgery, 50 percent more likely to get angioplasties, and 38 percent more likely to receive angiographies, which involve injecting a dye into the bloodstream to reveal blockages in X-rays, the study said.

Dr. Whittle noted that medication for heart disease is the alternative to invasive techniques, and "perhaps blacks are less willing to call for what may be a risky procedure."

Also, he said, black patients may have other medical problems that make the invasive techniques dangerous.

Dr. Whittle said, however, that the issue of racism should not be overlooked. "I would be naive in thinking that physicians are immune to racism . . . If you see a potentially valuable technique not being used by the black community, you have to wonder."

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