Heart Disease Deaths Show Racial Gap

Nov. 13, 2006 (Chicago) -- Blacks are more likely to die of atherosclerosis than whites over the next decade -- despite the same degree of heart disease, according to a new study.

The study is one of the largest comparing long-term heart disease outcomes for blacks and whites. It was presented at the annual scientific sessions of the American Heart Association (AHA).

The nine-year study evaluated more than 20,000 people with serious coronary artery disease. At the completion of the study, 36% of the blacks were still alive, compared with 46% of the whites.

Coronary artery disease is a form of atherosclerosis in which arteries that supply blood to the heart become severely narrowed due to the buildup of plaque.

In general, the black participants tended to have other risk factors that placed them at higher risk of dying, researcher Kevin Thomas tells WebMD. "But that didn't explain the entire disparity." Thomas is a cardiology fellow at the Duke Clinical Research Institute in Durham, N.C.

Risk Factors May Play Role in Racial Disparities

For the study, the researchers analyzed the outcomes of 21,054 men and women diagnosed with serious coronary artery disease between 1986 and 2004; more than 3,000 participants were black.

Black participants tended to be younger at diagnosis, Thomas says. "They were also heavier. And they were 12% more likely to have diabetesdiabetes, 15% more likely to have high blood pressurehigh blood pressure, and 13% more likely to have renal disease."

But even after the researchers took these factors into account, the disparity in death rates persisted, Thomas says.

"After adjustment, blacks were still 8% more likely to die than their white counterparts, which told us other factors must be at play," he says.

Less Likely to Get Bypass Surgery

The researchers found that whites were 12% more likely to receive coronary bypass surgery -- a surgical procedure that reroutes the heart's own blood supply and improves the flow of oxygen to the heart.

Thomas isn't sure why. One possible explanation is that some doctors may have been biased against blacks, whether intentionally or not, he says.

Also, many blacks have a historical mistrust of the medical system and may not have been as willing to undergo bypass surgery, an invasive procedure which usually involves cracking open the chest.

Biological differences also exist that have yet to be understood and socioeconomic status may also help explain blacks' poorer outcomes, says Richard Stein, MD, an AHA spokesman and director of preventive cardiology at Beth Israel Medical Center in New York City.

Reducing Heart Risks

Thomas says that there are three important points to study going forward: "Why there is a difference in death rates, why blacks are less likely to get bypass surgery, and why blacks have such high rates of high blood pressure and diabetes."

In the meantime, there are steps blacks can take to reduce their risk of developing coronary artery disease in the first place, he says.

"My advice is to control the things you can control," he says.

"Work on your diet -- as a bad diet and obesityobesity can both lead to high blood pressure, diabetes and, eventually, heart problems and death. Exercise. And don't smoke."

SOURCES: American Heart Association's Scientific Sessions 2006, Chicago, Nov. 12-15, 2006. Kevin Thomas, MD, cardiology fellow, Duke Clinical Research Institute, Durham, N.C. Richard Stein, MD, AHA spokesman; director, preventive cardiology, Beth Israel Medical Center, New York City.