ATLANTA - Doctors know that heart disease patients who have a limited education and few economic resources are more likely to die, but now researchers at Duke University Medical Center are beginning to learn why: many can't pay for life saving medications and don't receive preventative care.

Cardiologist Chen Tung and his Duke colleagues prepared their findings for presentation Tuesday at the 47th scientific sessions of the American College of Cardiology. The study is part of a National Institutes of Health-funded "Moderators of Social Support (MOSS)" study.

"It's well known that heart patients with low socioeconomic status do not do as well as other heart disease patients," Tung said. "We focused on how lower income may affect how long people live."

Patients with less than nine years of education and an income of less than $10,000 per year also were older, more likely to be female and had more hypertension. Frequently, these patients are living on a fixed income without adequate insurance to cover medication costs. They also receive less cardiac rehabilitation, according to the study of 523 heart disease patients at Duke.

"This should be a wake-up call to physicians and the health care industry in this cost-conscious age," said Tung. "Right now there are no interventions specific to cardiac patients with low incomes and limited education to improve their survival."

The patients all received cardiac catheterization, which confirmed coronary artery disease, and were prescribed medicine to control their disease. One month later, patients were interviewed about their medications, out-of-pocket medication costs and whether they had not taken their medications because of cost. After six months, doctors followed up with patients to determine what preventive or emergency visits they had.

The study revealed that heart disease patients with an income of less than $10,000 per year and less than
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Contact: Karyn Hede George
Georg016@mc.duke.edu
919-684-4148
Duke University Medical Center
31-Mar-1998