People at lower socioeconomic levels have higher death rates within 5-10 years after heart surgery

Apr 06, 2010

People at lower socioeconomic levels die more often within five to 10 years after heart surgery than those at higher socioeconomic levels, regardless of race and gender, according to research reported in Circulation: Cardiovascular Quality and Outcomes, an American Heart Association journal.

In the study, researchers tracked the survival of 23,330 people (15,156 white men, 6,932 white women, 678 black men and 564 black women) who underwent heart bypass or between 1995 and 2005.

Researchers found that each drop in had a corresponding "dose-dependent" decrease in the long-term survival rate. Specifically, after adjusting for existing risk factors such as and diabetes, patients in the lowest socioeconomic position had a 19 percent to 26 percent higher chance of dying within five years of surgery compared to their counterparts in the highest socioeconomic position.

"We were surprised that consistently and pervasively, through every way of looking at the data, it turns out this isn't about skin color or gender. It's about being poor," said Colleen G. Koch, study author, cardiac anesthesiologist and vice chair for research and education in the Department of Cardiothoracic Anesthesia at the Cleveland Clinic in Cleveland, Ohio.

Patients in lower socioeconomic positions had more atherosclerosis, serious cardiovascular disease, prior heart attacks, left ventricular dysfunction and . They also had more hypertension, prior stroke, peripheral artery disease and treated diabetes, were more often smokers and had more .

The study showed significantly higher numbers of blacks and women in lower socioeconomic positions than whites and men.

Researchers used six categories of U.S. Census data linked to patients' neighborhoods (including median household income, educational level and median home value) to determine socioeconomic position. They evaluated patients' socioeconomic factors and risk-adjusted health outcomes starting six months after heart surgery. Median follow-up was 5.8 years.

The study followed and valve surgery patients because of the well-known risk factors and results of these fairly common types of heart operations.

Death rates among patients with a lower socioeconomic position were not significantly higher while patients were in the hospital immediately following surgery, Koch said. "There's something in particular about the follow-up period in the 10 years afterward that's making them more likely to die."

Lack of referrals to cardiac rehabilitation programs after surgery, educational barriers and financial obstacles could all contribute to poor health outcomes in follow-up years, she said.

Survival might be improved in patients in lower socioeconomic positions by improving access to primary prevention, identifying risk factors sooner, delivering secondary prevention and increasing access to long-term interventions, Koch said.

Explore further: West Africa's Ebola outbreak prompts changes in I.Coast cuisine

add to favorites email to friend print save as pdf

Related Stories

Income, education, important factors in heart disease risk

Jun 16, 2009

Doctors who ignore the socioeconomic status of patients when evaluating their risk for heart disease are missing a crucial element that might result in inadequate treatment, according to a University of Rochester Medical ...

Risk factors of cardiovascular disease rising in poor, young

Jul 20, 2009

Cardiovascular disease is increasing in adults under 50 and those of lower socioeconomic status, despite recent trends which show that cardiovascular disease is declining in Canada overall, say researchers at the Peter Munk ...

Study: Sticking with heart rehab boosts survival

Dec 21, 2009

(PhysOrg.com) -- Medicare beneficiaries with heart disease who attended more cardiac rehabilitation sessions had fewer heart attacks and were less likely to die within four years than those who went to rehab less, researchers ...

Higher wealth linked to lower stroke risk from age 50 to 64

Apr 24, 2008

Higher wealth is linked with a lower risk of stroke in Americans between the ages of 50 and 64, but does not predict strokes in those over age 65, researchers reported in Stroke: Journal of the American Heart Association.

Recommended for you

Two expats die of MERS in Saudi commercial hub

18 hours ago

Two foreigners died of MERS in the Saudi city of Jeddah, the health ministry said Saturday, as fears rise over the spreading respiratory virus in the kingdom's commercial hub.

UAE reports 12 new cases of MERS

18 hours ago

Health authorities in the United Arab Emirates have announced 12 new cases of infection by the MERS coronavirus, but insisted the patients would be cured within two weeks.

Filipino tests negative for Middle East virus

Apr 19, 2014

A Filipino nurse who tested positive for the Middle East virus has been found free of infection in a subsequent examination after he returned home, Philippine health officials said Saturday.

User comments : 0

More news stories

Cancer stem cells linked to drug resistance

Most drugs used to treat lung, breast and pancreatic cancers also promote drug-resistance and ultimately spur tumor growth. Researchers at the University of California, San Diego School of Medicine have discovered ...

Making graphene in your kitchen

Graphene has been touted as a wonder material—the world's thinnest substance, but super-strong. Now scientists say it is so easy to make you could produce some in your kitchen.