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(Circulation. 2003;108:1041.)
© 2003 American Heart Association, Inc.

Focused Perspective

Explaining Racial Disparities in Coronary Outcomes in Women

William S. Weintraub, MD; Viola Vaccarino, MD, PhD

From the Department of Medicine, Emory University, Atlanta, Ga.

Correspondence to William S. Weintraub, MD, Professor of Medicine, Emory University, 1256 Briarcliff Rd, Suite 1N, Atlanta, GA 30306. E-mail wweintr@emory.edu

Key Words: Editorials • prognosis • risk factors

An extract of the first 250 words of the full text is provided, because this article has no abstract.

There remains no more combustible a set of issues in American life than concern over race and gender. Much of this concern is fundamentally over economic issues relating to disenfranchisement. This translates in medicine into disparities in access to care, care delivered, and patient outcomes.

See p 1089

Differences in care and outcome of coronary disease have been shown to differ between white and black women, but the literature offers a mixed and complex picture. There would be little doubt about the presence of a disparity if there could be shown to be a disparity in survival at the population level. In the community-based Charleston Heart Study, 741 white women and 454 black women were monitored for up to 30 years.¹ The mortality rate from coronary disease was 2.1 (1.6 to 2.6) per 1000 person-years for white women and 3.2 (2.3 to 4.0) for black women. This trend, with a relative risk of 1.5 comparing black with white women, did not achieve statistical significance (P=0.17). However, the cardiac mortality rate was low, as only 3% of women had coronary disease at baseline, and the sample size was somewhat small. Similar findings were noted in the Evans County study.² Overall, the literature comparing long-term cardiovascular mortality in white and black women is quite limited, making it difficult to draw firm conclusions concerning the societal level of risk.

Much of the concern in the literature has been about referral to diagnostic cardiac catheterization and subsequent referral to revascularization. This issue . . . [Full Text of this Article]

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