ETHNIC minority heart failure patients were found to have a 36 per cent higher risk of death compared to white patients over an average follow-up period of 17 months, according to a new study.
The disparity is even more pronounced in patients who also suffer from atrial fibrillation, a common heart rhythm disorder, the study published on Monday (3) has revealed.
In this subgroup, ethnic minority patients were more than twice as likely to die compared to white patients, even after adjusting for factors like age.
Beta blockers, a common treatment for heart failure and atrial fibrillation, showed a 30 per cent reduction in death rates for white patients, researchers have found out after analysing data from over 16,700 patients.
However, the analysis did not demonstrate a significant protective effect for ethnic minority patients, potentially due to the under-representation of these groups in clinical trials. Across the 12 clinical trials analysed, 89 per cent of participants were white, underscoring the need for more inclusive research.
The study by researchers at the University of Birmingham, supported by the British Heart Foundation and presented at the British Cardiovascular Society conference in Manchester, also highlighted significant disparities in heart failure treatment and outcomes.
Sebastian Fox, a final-year medical student and co-lead author, stressed the importance of addressing the disparity.
He said, “It is crucial that steps are taken to close this worrying gap in heart failure treatment and outcomes. The most important thing we can do going forward is include more ethnic minority patients in trials of heart failure treatments. We otherwise risk drawing inappropriate conclusions that treatments are equally effective across different ethnicities.
“Another important factor to address is the combination of barriers to healthcare facing ethnic minority patients, resulting in later presentation to a doctor with a more advanced form of heart failure. This in turn is likely to lead to poorer outcomes for these patients. We need to investigate the root causes of these differences and find solutions to potential barriers these groups experience when seeking healthcare.”
The researchers pointed to several potential causes for the disparities. Evidence from other studies suggests that ethnic minority patients often seek medical help later, when their condition is more advanced and harder to treat. Additionally, there may be differences in the effectiveness and use of treatments among different ethnic groups.
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Hospitalisation rates also differed significantly between the groups. Nearly one-third of ethnic minority heart failure patients were hospitalised for cardiovascular issues, compared to one-quarter of white patients. For those with atrial fibrillation, around 40 per cent of ethnic minority patients were admitted to hospitals versus 30 per cent of white patients.
Dr. Sonya Babu-Narayan, associate medical director of the British Heart Foundation and a consultant cardiologist, indicated that the study underscores significant health disparities in heart failure outcomes based on a patient's ethnicity.
“While this study was observational and cannot tell us about cause and effect, it found that patients with an ethnic minority background were sicker and more likely to die from their heart failure than others," she said.
“If we are to close this gap, it is vital we gain a better understanding of barriers in accessing care that face those from minority ethnicity backgrounds. It is also important that research is representative of those affected by cardiovascular disease, to ensure that tests and treatments can benefit those who need them. If you have been prescribed medications for heart failure, it important to take them as recommended by your doctor.”
Vikram Doraiswami
Andrew Quintman
Lord Jitesh Gadhia 
