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White Men With Chest Pains Treated Fastest in ERs
Date:3/14/2008

Government study found minorities, women not given heart treatments as quickly

FRIDAY, March 14 (HealthDay News) -- White men who arrive in emergency rooms complaining of chest pains get treatments for heart trouble faster than African-Americans or women do, a new U.S. government study finds.

Researchers looked at more than 19 million emergency room visits and found that whites who reported angina were 1.6 times more likely than nonwhites to be seen by a medical staff member within 10 minutes, and men were 1.5 times more likely than women to get that quick reaction, said study author Dr. Jing Fang, an epidemiologist with the U.S. Centers for Disease Control and Prevention. He was expected to report the findings at the American Heart Association's Cardiovascular Disease Epidemiology and Prevention Annual Conference in Colorado Springs.

Those numbers are not clear-cut evidence of discrimination on the basis of race and sex, Fang said, since emergency room responses may be based on evidence that ischemic heart disease -- blockage of coronary arteries that causes chest pain -- is more common among those who get faster treatment, and that chest pains are more likely to have other causes in nonwhites and women.

"When you see that the percentage of ischemic heart disease is higher among whites than nonwhites and among men than women, maybe the health-care providers who decide who gets treated first are thinking that whites are more likely to have ischemic heart disease, men are more likely to have ischemic heart disease," she said.

The study found no difference in response time or treatment based on age. Emergency room service was the same for visitors complaining of chest pains who were over 65 and those who were younger.

But treatments were different for the sexes and races. Men were 1.5 times more likely than women to get an electrocardiogram and 1.7 times more likely to be given a beta-blocker heart drug. Whites were 1.8 times more likely than nonwhites to get an electrocardiogram and 1.5 times more likely to be prescribed drugs for chest pain.

The study did not show whether the difference in treatment made a difference in outcomes such as mortality or hospitalization, Fang said. "We were unable to note the outcome, short-term or long-term mortality," she said. "A follow-up study would be nice."

Two other reports presented at the same conference showed clear ethnic influences on incidence and awareness of cardiovascular disease in the American population.

A study of Native Americans done at the University of Oklahoma found they had a higher incidence of stroke and were more likely to have a first stroke at an early age than whites and African-Americans. The incidence of stroke among Native Americans in the study was 679 per 100,000 person-years, higher than among other Americans, and the average age when a first stroke occurred was 66.5 years, earlier than in the general population.

And a study of health beliefs done at Columbia University found that members of racial or ethnic minorities were less likely to adopt prevailing views of cardiovascular disease prevention than other Americans. Minorities were more likely to place faith in a higher power than on personal actions to prevent disease, the researchers found. The finding "may represent a unique opportunity for education and early intervention," they said.

More information

The many possible causes of chest pain are described by the U.S. National Library of Medicine.



SOURCES: Jing Fang, M.D., epidemiologist, U.S. Centers for Disease Control and Prevention, Atlanta; March 13-14, 2008, presentations, American Heart Association Cardiovascular Disease Epidemiology and Prevention Conference, Colorado Springs, Colo.


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