DALLAS, July 2 -- African-Americans are less likely than Caucasians to undergo an important surgery designed to prevent stroke, according to a study published in this month's Stroke: Journal of the American Heart Association.
The study of 803 men hospitalized at four Veterans Affairs hospitals also found that black patients are less likely than whites to receive a diagnostic imaging test that is a crucial first step in determining whether an individual is a candidate for the surgical procedure called carotid endarterectomy.
"We can rule out financial barriers as an explanation for our study's findings because patients in the VA system have equal financial access," says Eugene Oddone, M.D., director of the Center for Health Services Research in Primary Care, VA Medical Center in Durham, N.C., and chief/division of general internal medicine, Duke University Medical Center. Oddone was the lead researcher in the study.
Carotid endarterectomy surgically removes plaque buildup in an artery of the neck that supplies blood to the brain, thereby reducing the likelihood of a stroke. People who have a blockage in the carotid artery are at high risk for stroke as well as for transient ischemic attacks (TIAs), or 'mini-strokes.'
The study examined men 45 years of age and older who were hospitalized for stroke or TIA at one of four VA hospitals between 1991 and 1994. The percentage of blacks and whites in the study was similar, according to Oddone.
"We were trying to answer the question of whether or not African-American
patients had equal access to this important surgical procedure," says Oddone.
"We found there were clinical differences between the two groups of patients.
For example, the black patients on average had a smaller amount of blockage in
their carotid artery. However, even after that fact and other clinical factors
were taken into account, there were still racial discrepancies. In other words,
Contact: Carole Bullock
American Heart Association