Women, Minorities Lag in Heart Attack Care

Cardiac risk is high for women and minorities with heart disease yet prevention efforts are behind

(RxWiki News) Heart attack patients can take steps to lower their risk of future cardiac events, such as losing weight and managing high blood pressure. Some high-risk groups, however, could be doing more.

When patients leave the hospital after having a heart attack, they can reduce their chances of having another heart attack by controlling blood pressure, weight, diabetes, cholesterol and other risk factors.

A new study found that women and minorities in particular may be missing opportunities to modify behaviors and treat issues that threaten their health.

"Seek help from your doctor to prevent future heart attacks."

Erica Leifheit-Limson, PhD, associate research scientist in epidemiology at the Yale School of Public Health in New Haven, Connecticut, and co-authors evaluated cardiac risk factors and management strategies among 2,369 patients hospitalized for heart attack, or acute myocardial infarction (AMI).

On average, participants were 61 years old, predominately male (67 percent) and white (78 percent). The analysis was limited to patients who were white or black because of “...the small proportion of patients representing other races.”

The scientists looked at the prevalence of hypertension (high blood pressure), hypercholesterolemia (high levels of cholesterol in the blood), smoking, diabetes and obesity.

About nine out of ten patients had at least one of these risk factors. About seven in ten had two or more, and four out of ten had three or more.

Multiple risk factors were markedly higher among blacks compared with whites, according to the investigators, with black women having the greatest risk burden of any group.

The researchers discovered that 60 percent of older black women and 54 percent of younger black women had three or more risk factors.

Black patients were less likely to pursue secondary prevention efforts to stop smoking compared with white patients. Secondary prevention strategies are directed toward reducing the severity of an existing condition while primary prevention aims to reduce the number of new cases.

The study authors also pointed out that younger black patients were less frequently prescribed antihypertensive and lipid-lowering (cholesterol) medications compared with younger white patients.

Sarah Samaan, MD, cardiologist and physician partner at the Baylor Heart Hospital in Plano, Texas, told dailyRx News, “The majority — as much as 85 percent — of heart disease is preventable through a combination of healthy lifestyle and medical therapy.

"The study doesn't offer any specific insights into why the care differed so substantially. The study took place in 2003-2004, when many important drugs were not available in generic form. Fortunately, we now have a wide variety of medications that work extremely well and can be had for $4 per month for cash-paying patients," said Dr. Samaan.

“These findings indicate missed opportunities for both prevention and management of cardiac risk factors, particularly for women and minority patients," said Susan Kornstein, MD, editor-in-chief of Journal of Women's Health, executive director of the Virginia Commonwealth University Institute for Women's Health in Richmond and president of the Academy of Women's Health.

This study was published in August in the Journal of Women's Health.

Review Date: 
August 27, 2013