Black heart attack survivors often fare worse than their white counterparts, according to a new study.

The one-year death rate for blacks after hospitalization for heart attack is 1.7 times higher than for whites, say the researchers, who included Rajendra Mehta, MD, of Duke University Medical Center.

Blacks also have higher rates for stroke or major bleeding while getting clot-busting drugs in the hospital, find Mehta and colleagues, who reported the findings at the American Heart Association’s Scientific Sessions 2004.

The numbers are based on data from several large trials totaling more than 32,000 U.S. heart attack survivors. Blacks made up about 5 percent of the group.

The study focused on the most severe kind of heart attack. These heart attacks victims tend to have the worst short- and long-term outcomes, according to an American Heart Association news release.

While in the hospital and during the first 30 days of follow-up, black and white heart attack victims were similar in survival. The 30-day death rate was 6.7 percent for blacks and 6.6 percent for whites. However, after one year the death rate was different: 5 percent for blacks and 2.9 percent for whites, says the release.

Along with poorer long-term health prospects, blacks also differed from white heart attack survivors in several other ways.

Black heart attack patients were more likely to be younger, female, smokers, and have high blood pressure, diabetes, and obesity, write the researchers. The average age for a black heart attack patient in the study was 57; for a white heart attack patient, it was 61.

Black patients tended to have arteries that responded better to treatment and were less likely to have severe hardening of the arteries, says Mehta in the release.

The researchers say they aren’t sure how to explain the racial gap, and they call for detailed studies with large numbers of black participants to find ways to improve the health of black heart attack survivors.

Compliance with long-term drug therapy, mistrust of the medical system, and lack of medical insurance may be part of the problem, says Mehta in the release.

By Miranda Hitti, reviewed by Brunilda Nazario, MD

SOURCES: American Heart Association Scientific Sessions 2004, New Orleans, Nov. 7-9, 2004. News release, American Heart Association.