Cardiac program helps alleviate racial disparities in care, study shows

Hospitals have improved access to appropriate care and reduced mortality for Hispanic and African-American cardiac failure patients, according to a study published this week in the American Heart Journal

The study teased out a few critical factors in treating patients of different races, which, when addressed through a comprehensive care initiative from the American Heart Association -- Get With the Guidelines (GWTG) -- meant Hispanic and African-American patients were actually less likely to die in the hospital than whites, the study reveals. African-American patients had a 31% lower mortality rate, while Hispanics had a 19% lower risk of dying.  

One of the big issues researchers uncovered was age. African-American and Hispanic cardiac patients tend to be younger, developing heart failure in their 60s, compared to whites, who typically don't present until in their late 70s. And minority patients made up a far larger percentage of patients who developed heart failure in their 40s and 50s. This led to developing different educational approaches for whites versus Hispanic and African-American patients, the study reports.

Another key factor researchers may have identified: That whites develop heart failure for different reasons than Hispanics or African-Americans. Whites tend to suffer from heart failure after having a heart attack, while minority patients often present as a result of conditions like diabetes and high blood pressure. This issue wasn't one that the GWTG program particularly addressed, and needs further study, the Journal article indicates.

The study covered 78,801 patients from 257 hospitals in the GWTG program from January 2005 to December 2008. The GWTC program pushes hospitals to institute a strict, comprehensive approach to heart failure care, including advanced cardiac training for clinicians, multidisciplinary team rounding, and standardized clinical tools, such as checklists and order sets.  

On a related note, another study last month addressed the issue of the race/heart failure issue. An article in the journal Medical Care found that different races often do receive different treatments for heart failure. For example, white and Hispanics are more likely than African-Americans to receive medication as a primary treatment. However, the data showed that the treatment differences don't lead to any higher risk of hospitalization for African-Americans.

For more information: 
- access the study abstract
- read the Medical Care study
- read this press release
- read how one hospital implements the GWTG guidelines

Related Articles:
Disparities in heart attack treatment may begin in the emergency room
ER triage decisions delay care for blacks, Hispanics
Study: Blacks do worse than whites after cardiac arrest