After a heart attack, life expectancy can depend on many factors. Now new evidence suggests that even a patient's sex and skin color may play a role.
A new study found that women and black patients lost more years of their expected lives after a heart attack when compared to white men. According to the authors of this study, this may be due to inadequacies in health care between the groups.
While past research has looked at sex and racial differences in heart attack survival, this was the first study of its kind to account for women's longer average life expectancy and the shorter average life expectancy of black patients.
"Prior research has shown that women and men have similar mortality after a heart attack," said lead study author Emily Bucholz, MPH, a pediatric resident at Boston Children's Hospital, in a press release. "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."
Bucholz and team used data from the Cooperative Cardiovascular Project to track 146,743 heart attack patients on Medicare for 17 years. Of these patients, 48.1 percent were women and 6.4 percent were black.
Compared to white men, both of these groups were more likely to have diabetes, high blood pressure and heart failure.
After 17 years, the survival rate for white men was 8.3 percent while the rate for white women was 6.7 percent.
The survival rates for black men and black women were 5.4 percent and 5.8 percent, respectively, after 17 years.
Because women generally have a longer life expectancy than men, women tended to lose significantly more years of life than men.
Bucholz and team estimated that, on average, a 65-year-old white man lost 5.1 years of life after a heart attack. A 65-year-old white woman lost 10 years.
The differences between black men and black women were much less significant.
On average, a black man lost 0.3 more years of life than a white man. A black woman lost one more year of life than a white woman.
According to Bucholz and team, these racial differences can be explained by differences in health care and other health conditions that affect the heart.
The reasons behind the differences for women, however, are still unknown.
In an editorial about this study, Jack V. Tu, MD, PhD, of the Sunnybrook Research Institute in Toronto, Canada, wrote, "Their analyses reinforce the need to improve the clinical presentation and treatment of all [heart attack] patients but especially those of black race."
This study was published in the August issue of the Journal of the American College of Cardiology.
No funding sources were disclosed.
Study author Harlan Krumholz, MD, worked under contract with the US Centers for Medicare and Medicaid Services to develop and maintain performance measures.