African Americans fare less well than whites after stroke preventi...( that whites were twice as likely to un...)

Nationally, physicians perform more than 130,000 CEAs annually to clear plaque from the inner lining of the carotid artery, one of the main arteries supplying blood to the brain. Blocked carotid arteries are one of the most common causes of stroke.

"Previous studies have shown that CEA is performed less frequently in African Americans. And some researchers hypothesize that there is a perception that African Americans don't do as well with the surgery, so doctors are less likely to recommend the operation," says Perler. "But until now, community-wide studies have not investigated the influence of race on the outcome of surgery. This study suggests that it is not necessarily genetic, but socioeconomic factors that are influential in determining surgical outcome."

"There is no question that surgeons and hospitals that do the most procedures get the best results, and we found that African Americans are going to different hospitals as a group than whites," continues Perler. "African Americans are more likely to undergo surgery in low-volume hospitals and are less likely to have the operation performed by the most experienced surgeons. African Americans tend not to get optimal medical care in terms of this operation, and we think it is an important social issue."

The researchers say the question of unequal access to optimal surgical care is particularly concerning in view of the infrequency with which CEA is performed on African Americans. The researchers say the current study supports the hypothesis that some doctors may not recommend CEA to African Americans because they are at an increased risk for complications of the pr
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Contact: Kate O'Rourke
korourke@jhmi.edu
410-955-8665
Johns Hopkins Medical Institutions
1-Nov-2000