News | Womens Healthcare | August 18, 2015

Women, Blacks Face Larger Loss of Life Expectancy After Heart Attack

Differences in life expectancy change may be due to disparities in care

women, blacks, larger loss of life expectancy, heart attack, JACC, study, Harlan Krumholz, Emily Bucholz

August 18, 2015 — Women and black patients lost more years of their expected life after a heart attack when compared to white men, according to a study published in the Journal of the American College of Cardiology.

Previous research has looked at sex and racial differences in survival after a heart attack, but this was the first study to account for women’s longer life expectancy in the general population and the shorter life expectancy of blacks.

“It is imperative that we understand whether disparities we observe in a specific group, like people with heart attacks, is particular to them or more broadly reflective of the experience in the population,” said Harlan Krumholz, M.D., FACC, senior study author and director of the Yale-New Haven Hospital Center for Outcomes Research and Evaluation. “We found that women and black patients are losing more years of their life after a heart attack 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.”

Researchers used data from the Cooperative Cardiovascular Project, a prospective cohort study that includes all fee-for-service Medicare beneficiaries discharged from acute-care non-governmental U.S. hospitals with a heart attack diagnosis in the mid-1990s.

"Prior research has shown that women and men have similar mortality after a heart attack,” said Emily Bucholz, M.P.H., lead author of the study and a pediatric resident at Boston Children's Hospital. “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."

The study authors reviewed records from 146, 743 heart attack patients. Overall 48.1 percent of patients were women and 6.4 percent were black. Women and black patients had a higher prevalence of diabetes, hypertension and heart failure compared with white men. One of the limitations of the study was that black patients represented such a small portion of the cohort.

After 17 years of follow-up, the survival rate was 8.3 percent for white men, 6.4 percent for white women, 5.4 percent for black men and 5.8 percent for black women. However, when adjusting for differences in expected survival, women lost significantly more years of life than men. The researchers estimated that, on average, a 65-year-old white man loses 5.1 years of life after a heart attack and a white woman loses 10 years, translating to a 29 percent reduction in remaining life for men and a 41 percent reduction for women.

Black men lost 0.3 more years than white men and black women lost one more year of life than white women, equating to black patients losing 5 percent more of their expected life than white patients.

According to researchers, racial differences in life expectancy can be explained by differences in comorbidities and treatment utilization. This was not the case for women. After adjusting for differences in clinical presentation and treatment, women still lost more of their expected life than men.

“The paper again reminds us that we need to further explore the reason behind the disparity in life expectancy for female and black patients—both in our clinical practice and in our research,” said JACC Editor-in-Chief Valentin Fuster, M.D., Ph.D., MACC.

Other study limitations included 10 percent of patients were still living at 17 years of follow-up, which required extrapolation of the expected survival curves to calculate life expectancy; and quality of care for heart attack patients has improved since the mid-1990s, so the life expectancy estimates may not accurately reflect patients today.

For more information: www.acc.org

Related Content

NIAID Scientists Illuminate Mechanism of Increased Cardiovascular Risks With HIV
News | Cardiac Diagnostics| September 14, 2017
September 14, 2017 — Scientists at the National Institutes of Health have expanded the understanding of how chronic i
Marijuana Associated With Three-Fold Risk of Death From Hypertension
News | Hypertension| September 14, 2017
Marijuana use is associated with a three-fold risk of death from hypertension, according to research published recently...
News | Cardiac Diagnostics| September 12, 2017
Contracting shingles, a reactivation of the chickenpox virus, increases a person’s risk of stroke and heart attack,...
Vascular screening for abdominal aortic aneurysm, peripheral artery disease and hypertension during the VIVA Study in Denmark

Vascular screening for abdominal aortic aneurysm, peripheral artery disease and hypertension during the VIVA Study. Photo credit: Lisbeth Hasager Justesen, Viborg Hospital.

News | Cardiac Diagnostics| September 12, 2017
September 12, 2017 — A new screening program for vascular disease saves one life for every 169 men assessed, accordin
PURE study may cause revision of fat intake guidelines for cardiology.
Feature | ESC| September 07, 2017
September 7, 2017 — Researchers at the European Society of Cardiology (ESC) Congress called for a reconsideration of
Florida Medical Center First in State to Offer High Sensitive STAT Blood Test
News | Blood Testing| September 07, 2017
In July, The Heart Institute at Florida Medical Center became the first hospital in the state of Florida to offer the U...
Heart Failure Patients, Clinicians Have Differing Perceptions of Risk Level
News | Heart Failure| September 06, 2017
September 6, 2017 — Physicians identified a majority of patients with advanced...
Advances in FFR, FFR-CT, was the most popular cardiology story in August 2017.

The most popular article in August was about advances in fractional flow reserve (FFR) technologies. The image shows Philips' new version of its iFR system that displays hemodynamic pressure drop points in an overlay on live angiographic images, matching up the iFR readings with corresponding lesions.

Feature | September 01, 2017 | Dave Fornell
September 1, 2017 — Here is the list of the most popular articles and videos on the Diagnostic and Interventional Car
Sponsored Content | Videos | Cardiovascular Ultrasound| August 30, 2017
This video educational session, provided in partnership with the American Society of Echocardiography (ASE), is title
HeartSciences Announces CE Mark and European Launch of MyoVista High Sensitivity ECG

Just as a Doppler radar color image shows the energy of a storm, MyoVista provides physicians a detailed visual image of the energy distribution during the cardiac cycle.

News | ECG| August 22, 2017
HeartSciences announced the European launch of the MyoVista high sensitivity electrocardiograph (hsECG) Testing Device...
Overlay Init