Women, black patients have poorer life expectancy after heart attack

5 Aug

Women and black patients will lose more years of expected life after a heart attack compared with white men, according to a new study.

A chart showing difference in life expectancy.
Women and black patients suffered greater loss of potential life.
Image credit: Journal of the American College of Cardiology

The study, published in the Journal of the American College of Cardiology (JACC), not only takes into account the longer life expectancy of women but also the shorter life expectancy of African-Americans in comparison to the general population – a first for studies investigating the effects of heart attacks.

Lead study author Emily Bulcholz, PhD, explains:

“Recognizing that women in the general population live longer than men, we asked the question of whether women who have a heart attack are actually at a survival disadvantage because they are losing more years of life after the event than men.”

Heart disease is currently the leading cause of death for both men and women in the world. Every year, an estimated 735,000 people in the US will suffer a heart attack, and around two thirds of these cases will be a person’s first.

A heart attack occurs when a segment of the heart muscle stops due to loss of blood. The cause of this is usually a blood clot within the coronary artery, which supplies blood to the heart muscle.

Dr. Valentin Fuster, the editor in chief of JACC, believes the study was more interested in the concept than actual specific results.

The concept he is referring to is the idea of years of potential life lost (YPLL), which is a metric tool to estimate the average time an individual would have lived. It is often used as an alternative to death rates for analysis.

Lower survival rates for women and black patients

Researchers examined records from the Cooperative Cardiovascular Project – a prospective cohort study that includes all fee-for-service Medicare beneficiaries discharged from acute-care non-governmental US hospitals with a heart attack since the mid-1990s.

A total of 146,743 cases of heart attack patients were recorded. Women made up 48.1% of the total and 6.4% were black.

After a 17-year follow up, results revealed the survival rate for white men was the highest at 8.3%, followed by white women at 6.4%.

The percentage for black patients was lower; the survival rate for black men and women were 5.4% and 5.8%, respectively.

Given women’s higher life expectancy, they were found to have lost many more years of YPLL compared with men.

Scientists estimated white women lost 10 years of life after a heart attack – almost double the 5.1 years of life lost by white men.

Black patients also fared worse following a heart attack, according to results. Black men were found to have lost 0.3 life more years than their white counterparts. This trend was also reflected in women, with black women losing a year more of life than white women.

One of the limitations acknowledged in the study is the small number of black patients represented in the sample group.

However, Dr. Harlan Krumholz, senior study author and director of the Yale-New Haven Hospital Center for Outcomes Research and Evaluation, CT, believes the results shed light on the disparity of treatment across groups. He says:

“We found that women and black patients are losing more years of their life after a myocardial infarction with one of the reasons potentially being they are not receiving care on par with men and white patients. The study makes clear the disadvantage of these groups and suggests that higher quality of care for everyone might be a helpful remedy.”

According to researchers, the racial differences in life expectancy can be attributed to the differences in comorbidities and treatment utilization.

However, women were still found to lose more of their expected life than men even after differences in clinical presentation and treatment were adjusted. Earlier this year, Medical News Today reported on Go Red For Women – a campaign to boost women’s awareness of heart disease.

In a corresponding editorial comment, Dr. Jack Tu, of the Institute for Clinical Evaluative Sciences in Ontario, Canada, says the results “reinforce the need to improve the clinical presentation and treatment” for all heart attack patients, especially those of black race.

Written by Peter Lam

Copyright: Medical News Today

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