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Black Women Under-Treated for Heart Disease

Posted on: Tuesday, 26 August 2003, 06:00 CDT

By Steven Reinberg, HealthDay Reporter

HealthDayNews -- Black women with heart disease are at higher risk for heart attack or death from heart disease, but they are being seriously under-treated compared with white women, a new study finds.

"We found that among women with heart disease, black women were twice as likely to have heart attacks or die from heart disease compared with white women," says study author Dr. Ashish Jha, a cardiologist from Brigham and Women's Hospital in Boston.

Part of the reason is that black women tended to have more severe heart disease. "But they are also less likely to be treated," Jha says.

Black women were less likely to receive aspirin or medications to lower cholesterol or blood pressure, he adds. "This lack of treatment contributed to worse outcomes for black women."

Jha and his colleagues studied 2,699 women with heart disease who enrolled in the Heart and Estrogen/Progestin Replacement Study. Among these women, 218 were black. The women were followed for an average of four years. The study appears in the Aug. 25 issue of Circulation.

The reasons for this disparity remain unclear, Jha says. "One thing that is clear is that women in general and their physicians underestimate the risk of heart disease in women. There is still the stereotype that heart disease is a man's disease," he explains.

The study reveals that treatment for all women with heart disease is mediocre. All of the women in the study, because they have heart disease, should be on aspirin and beta blockers and statins, Jha says: "I would argue that all the women were not being treated as aggressively as they should be."

Black women are at an especially high risk for heart disease. Nationally, black women have a 30 percent to 40 percent greater risk of dying from heart disease compared with white women, Jha notes. "This is something that is not well appreciated by patients or doctors."

He adds that "heart disease is the number one killer of all women, so women need to be aware of their heart disease risk and be more proactive patients."

"People at higher risk, namely black women, need to be treated more aggressively with medication and risk factor control," Jha stresses.

Noting that studies have found similar findings among black men, Jha speculates that race may play a role. "That's one troubling potential interpretation that we have to consider," he says.

Dr. Dan Fisher, a cardiologist from New York University Medical Center, comments that "this study confirms what we know -- that black women are at higher risk compared with white women."

For Fisher, the study raises the questions why black women are at higher risk for heart disease and how the problem can be approached.

The fact that these women were all part of a clinical trial and were still under-treated highlights the gap in treatment between white and black women and between all women and men, he says.

"Doctors and patients have to be aware of the risks of heart disease and do the best they can to treat them," Fisher says.

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On the Net:

National Heart, Lung, and Blood Institute

American Heart Association

Brigham and Women's Hospital

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