Low Socio-Economic Status Heart Patients Need More Than Just Aggressive Cardiac Procedures

ter treatment.

"We expected all patients to feel bad at the beginning, but we also expected them to get much better," Tung said. "What is so striking is after revascularization how much worse the low SES people felt compared to the higher SES people. We saw at least a 30 to 40 percent reduction in the functional status and quality of life despite having the aggressive procedures."

For Tung, the results show that heart procedures aren't magic bullets that can cure heart disease by themselves, especially for the poor and less educated.

"Much effort has been placed on providing equal access to care," Tung said. "While this is indeed important, especially for low SES patients, more fundamental changes are needed."

Tung believes that an educational component is critical to the medical care provided low SES patients. To this end, the Duke team is developing a pilot program for lower SES patients that stresses the importance of lifestyle and dietary changes.

Researchers used two different quality-of-life questionnaires to assess the functional status of patients. Each test was given to patients at the beginning of the study and again one year later.

The first, called the Duke Activities Status Index (DASI), is a questionnaire developed by Duke cardiologists in the mid-1980s that measures how much a person can do physically. The second test, called SF-36, is a questionnaire that measures patients' perceptions of their overall health. Taken together, the results of these two tools give researchers an insight into a patient's quality of life, Tung said.

The study was funded by a grant from the National Heart Lung Blood Institute. Dr. Daniel Mark was the senior Duke cardiologist on the study.


Contact: Richard Merritt
Duke University Medical Center

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