Racial disparities persist among black women seeking cardiac care

Despite improvements in heart attacks and heart disease in older women, black women still experience significantly lower treatment rates than whites or Hispanics, according to a preliminary study presented at the 2019 scientific sessions of the Quality of Care and Results from the American Heart Association, has the world's leading exchange on the latest advances in quality care and research findings on cardiovascular disease and stroke for researchers, health professionals and health and decision makers.

A two-decade study showed an overall increase in treatments for heart attacks and heart disease after the release of standard treatment guidelines in 2005, but racial disparities persisted. Specifically, menopausal black women were 50% less likely and Hispanic women 16% less likely to be treated when they arrived at the hospital with a heart attack or coronary heart disease symptoms compared to white women. This gap persists after accounting for education, income, insurance status and other cardiac complications such as diabetes and hypertension.

Cardiovascular disease is a leading cause of death, resulting in one death every 80 seconds in women. Fast treatment is essential and, although treatment rates seem to improve, they do not seem to improve in the same way for all groups.

Using data from the Women's Health Initiative, researchers examined the treatment rates of 20,262 postmenopausal women before and after 2005, including 17,509 Caucasian women; 2,181 blacks and 572 Hispanics. Among their other main conclusions:

• Black women with ST-elevation myocardial infarction (STEMI), the most serious type of heart attack in which an artery is completely blocked, had lower treatment rates before 2005 (15% less) and after 2005 (39% less) compared to whites.
• Restoring blood flow to the clogged artery within 12 hours of acute ischemia or heart attack is the method of choice, but black women had a 33% lower treatment rate, regardless of timing, and treatment rate 23% lower. receive it within 12 hours of the symptoms of the heart attack.
• Hispanic women with acute coronary syndrome or coronary artery disease were also subject to lower treatment rates before 2005 (23%), but the gap was slightly reduced after 2005 (7%).
• The researchers found no difference in treatment rates with respect to socio-economic status.

"Our study shows that black women continue to receive fewer treatments recommended for heart attacks and coronary heart disease than white women and that there is still a need to improve these racial disparities," Tarryn Tertulien said. , BS, lead author of the study and fourth-year medical student at The Brown University's Warren Alpert Medical School in Providence, RI "Public campaigns targeting racial minorities on the planet should be put in place. educating patients and developing a trusting relationship with the health system to improve this disparity in care. "

Tertulien said that if her study did not focus on the factors explaining these racial disparities, she explained that it was possible that blacks and Hispanics were not well aware of heart attack symptoms or are less likely to use emergency services, but may be reluctant to use invasive procedures to open blocked arteries. and there may be vendor bias. She added that further research is needed to understand the origins of these disparities and to work with patients, communities, hospitals and health care providers to develop rapid interventions for all.