Symptom expression in coronary heart disease and revascularization recommendations for black and white patients

M. Hravnak, J. Whittle, M.E. Kelley, S. Sereika, C.B. Good, S.A. Ibrahim and J. Conigliaro

American Journal of Public Health, 2007, vol. 97, issue 9, 1701-1708

Abstract: Objectives. We examined whether symptoms of coronary heart disease vary between Black and White patients with coronary heart disease, whether presenting symptoms affect physicians' revascularization recommendations, and whether the effect of symptoms upon recommendations differs in Black and White patients. Methods. We interviewed Black and White patients in Pittsburgh in 1997 to 1999 who were undergoing elective coronary catheterization. We interviewed them regarding their symptoms, and we interviewed their cardiologist decisionmakers regarding revascularization recommendations. We obtained coronary catheterization results by chart review. Results. Black and White patients (N=1196; 9.7% Black) expressed similar prevalence of chest pain, angina equivalent, fatigue, and other symptoms, but Black patients had more shortness of breath (87% vs 72%, P=.001). When we considered only those patients with significant stenosis (n=737, 7.1% Black) and controlled for race, age, gender, and number of stenotic vessels, those who expressed shortness of breath were less likely to be recommended for revascularization (odds ratio=0.535; 95% confidence interval=0.375, 0.762; P

Date: 2007
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Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2005.084103_9

DOI: 10.2105/AJPH.2005.084103

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