Black Women in the U.S. Still Missing Out on Heart Care
FRIDAY, April 5, 2019 (Pharmacist's Briefing) -- Older black American women are much less likely to be treated for heart attack and heart disease than white and Hispanic women, researchers say.
"Our study shows that black women still receive less recommended therapy for heart attacks and coronary heart disease than white women, and that improving these racial disparities is still needed," said study author Tarryn Tertulien, a fourth-year medical student at Brown University.
For the study, researchers used data from the Women's Health Initiative to assess treatment rates for more than 20,000 postmenopausal women before and after 2005, when standard treatment guidelines were released.
The study of more than 17,500 white women, nearly 2,200 black women and about 570 Hispanic women did find an overall increase in heart attack and heart disease treatment rates after publication of the guidelines, but racial disparities persisted.
Compared with white women, black women were 50% less likely and Hispanic women were 16% less likely to be treated when they arrived at a hospital with heart attack or heart disease symptoms, the findings showed.
The racial disparities remained after the researchers accounted for education, income, insurance status and other heart health complications, such as diabetes and high blood pressure.
The study also found that, among women with ST-elevation myocardial infarction (STEMI) -- the most serious type of heart attack where an artery is completely blocked -- black women had lower rates of treatment both before 2005 (15% lower) and after 2005 (39% lower) than white women.
Restoring blood flow to the blocked artery within 12 hours of an acute heart attack is the gold standard of treatment. However, black women had a 33% lower rate of receiving this therapy regardless of timing, and a 23% lower rate of receiving it within 12 hours of heart attack symptoms.
Hispanic women with acute coronary syndrome or heart disease also had lower rates of treatment before 2005 (23% lower), but the gap narrowed after 2005 (7% lower), according to the report.
The study did not examine the reasons for the racial disparities.
It's possible that black and Hispanic women may lack awareness about heart attack symptoms, be less likely to use emergency services or be hesitant about invasive procedures to open blocked arteries, according to Tertulien. Also, there may be racial bias on the part of health care providers, she added.
"Increasing public campaigns targeted at racial minorities regarding patient education and developing a trusting relationship with the health care system should be instituted to improve this disparity in care," she said in an American Heart Association news release.
The study was scheduled for presentation Friday at an American Heart Association meeting in Arlington, Va. Such research should be considered preliminary until published in a peer-reviewed journal.
Heart disease in the leading cause of death among U.S. women, with one death every 80 seconds.
The U.S. Office on Women's Health has more about heart disease.