DALLAS -- While aggressive procedures such as angioplasty and coronary bypass procedures improve the health of patients with heart disease, the benefits are less if patients don't have the financial means to protect that "investment" afterwards.

In a study of 800 patients, Duke University Medical Center researchers have found that heart patients of low socio-economic status (SES) have a worse quality of life after these aggressive forms of treatment than better-off and more educated patients.

"If patients don't understand what healthy living is or don't have the means to live healthier, they will not do as well, " said Duke cardiologist Dr. Chen Tung.

The issues facing this group of patients after treatment are complicated and not easily solved, Tung said. Most need to drastically change their lifestyles, may need physical rehabilitation, and need to take heart medications -- aspects of continuing medical care that can be either out of reach or not fully understood by most low SES patients.

Tung, who is on the faculty at the Duke Clinical Research Institute, prepared the results of his study for presentation Tuesday (Nov. 10) at the 71st scientific sessions of the American Heart Association meeting.

The study followed 800 consecutive patients who were referred to Duke for a cardiac catheterization and who then went on to receive either an angioplasty or bypass. Of these patients, 350 were of low SES, which was defined as having less than nine years of education and an annual income of less than $10,000. These patients tended to be older than high SES patients and a higher percentage were women.

The study found that patients from low SES came to the hospital sicker than high SES patients, and while both groups experienced small but marked improvements after either revascularization procedure, the functional status of lower SES patients remained significantly impaired one year af
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Contact: Richard Merritt
Merri006@mc.duke.edu
919-684-4148
Duke University Medical Center
10-Nov-1998