Heart failure: Black patients less likely to receive needed devices or transplants, study finds

CNN
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There is growing evidence that black heart failure patients are less likely than white patients to receive advanced treatment.

A study published in the journal Wednesday Circulation: heart failure Among adults with heart failure, they found that whites were twice as likely as blacks to receive heart transplants or ventricular assist devices (artificial heart pumps commonly used in patients with end-stage heart failure).

“The body of evidence suggests that we perpetuate current inequities as providers of heart failure,” said the study’s lead author and clinical researcher at the Department of Cardiovascular Diseases at the University of Michigan, Ann Arbor. Instructor Dr. Thomas Cascino said: said in a news release“But recognizing the disparities is not enough. As doctors and health care providers, we must find ways to create equitable change.”

Researchers analyzed data from 377 adults in the United States receiving treatment for heart failure between July 2015 and June 2016.

Data showed that heart transplantation or ventricular assist device was performed in 11% of black patients compared to 22% of white patients, but mortality was similar in both: 18 in black patients. %, 13% in Caucasian patients.

Patients’ preferences for ventricular assist devices, heart transplants, or other treatments did not affect the results, the researchers said.

“This remaining inequity may be the result of structural racism or discrimination, or provider bias that influences decision-making,” the researchers wrote.

Experts in the field say the findings confirm what doctors have been seeing for years.

“I can’t say I’m surprised,” said Dr. Jaimin Trivedi, an associate professor at the University of Louisville School of Medicine. who studied racial disparities in heart disease patientsHe was not involved in the new research.

Trivedi’s recommendation for getting cardiovascular care is to engage in your own health journey. Your family and loved ones should also be closely involved.

The new findings were no surprise to cardiologist Dave Montgomery, PhD, of Piedmont Healthcare in Atlanta.

“This study confirms what has been known for too long that black patients with heart failure have poorer outcomes, and that the poorer outcomes are partly due to gradients in the quality of care provided. “We are working on it,” said Dr. Montgomery, who was not involved in the new study.

“While we are not surprised to see the results of this study, the new information it provides is encouraging. “The problem is not as obscure and inaccessible as we believed in the past. Instead, it is a clear path to better care for all. indicates a serious intrusion.”

Bessie Young, Ph.D., adjunct professor of health systems and population health at the University of Washington, said people need to be educated on how to defend themselves and seek out options they may not know about, such as ventricular assist devices.

“For certain groups of people, getting these truly life-saving procedures and implants is difficult, and people don’t know who the gatekeepers for these devices are or how patients get them. It requires some sort of systematic change in how we think about our devices,” said Young.

Young, a health equity researcher who was not involved in the study, believes that inequality is driven by social determinants such as education and access rather than by biological determinants. I’m here.

Regarding the impact of this research on healthcare providers, she said: And that’s where people need to see how they’re evaluating people for getting devices and implants and make sure they’re using some sort of unbiased lens to do that. is. ”