Black patients with common heart disease are 25% less likely to receive drugs to prevent strokes

Black patients hospitalized with a common cardiovascular disease that can lead to stroke are 25% less likely to be prescribed potentially life-saving drugs, according to a new study that raises ‘puzzling’ questions about racial inequality in health care. , said its lead author.

The study found that black patients hospitalized for atrial fibrillation, the most common cardiovascular disease in the world, are 25% less likely to receive oral anticoagulants or blood thinners that prevent strokes and are 25% less likely to ‘be discharged on blood thinners than white patients. , shows the study.

“One of the biggest findings we’ve seen is that black patients had a twice as high risk of death if they weren’t discharged with these drugs,” said lead author Dr Utibe Essien. study and Assistant Professor of Medicine at the University. of Pittsburgh. “So it’s just not an important medicine that they give to a patient because it makes our quality results look good, it’s really a matter of life and death.”

Published Thursday and first presented Saturday at the Heart Rhythm Society’s annual conference at the Moscone Center in San Francisco, the study looked at hospitalized patients with atrial fibrillation from 2014 to 2020, a cohort that included about 70,000 patients from 159 hospitals across the country, Essien said. .

Patients with atrial fibrillation, an irregular heart rhythm disorder that causes the heart to skip a beat, are five times more likely to be at risk for stroke. Blood thinners are the standard medication prescribed for people with atrial fibrillation who are at risk of developing a stroke, Essien said. The condition affects up to 6 million people in the United States, he said.

While black people with atrial fibrillation have twice the risk of stroke and twice the risk of death, they are 25% less likely to receive medication to prevent stroke, the researchers said. Black people are also less likely to be prescribed newer, more effective drugs that treat the disease, called direct oral anticoagulants, Essien said.

Even when the researchers adjusted the data to weigh factors such as medical history, type of insurance, income, occupation, level of education and hospital, black patients were still less likely to see prescribe the potentially life-saving drug.

“Racial differences have really persisted even with those factors in our models, which really makes us try to push and figure out to go, ‘OK, what’s really going on in our patient conversations with their doctors? who makes these prescribing differences happen?’” Essien said, adding that talking to patients and doctors is the next critical step in understanding the disparities. “There must be something else that we just aren’t capturing in our data.”

Essien, a health disparities researcher whose work focuses on cardiovascular disparities, said the study’s results are “puzzling” and reiterated similar findings in his reviews of Medicare and Alumni health care. Combatants: that there are inconsistencies in access to medicines that otherwise should be equally accessible despite a person’s race and ethnicity.

Health care equity has “come to the forefront of our society” over the past two years, Essien said, referring to the coronavirus pandemic that has just exacerbated longstanding racial and ethnic disparities. in the health system.

“The focus is really going to be about not just these social class factors that we like to put our hats on, but really start to address some of the issues around structural racism and prejudice that could potentially explain some of these disparities that we’re seeing” , said Essien.

In addition to Essien, researchers from Stanford University, Northwestern University, Boston University, UCLA and the Duke Cardiovascular Research Center – who helped support the study – also co-authored the study.

Lauren Hernández (her) is a staff writer for the San Francisco Chronicle. Email: [email protected]: @ByLHernandez

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