Heart failure hits the poor extra hard

New York: Poor women are more likely to end up in the hospital with heart failure, even when taking other measures of health and well-being into consideration.

That`s according to a new study that also showed women who didn`t finish high school were at higher risk than those who received more education.

"It`s kind of a double insult," said Dr. Harlan Krumholz, a cardiologist at Yale School of Medicine in New Haven.

"They have to deal with social circumstances, and then when people get sick in that situation, it gets a whole lot worse. We need to try to intervene early to prevent these things from happening," he told a news agency.

The research involved about 26,000 healthy, post-menopausal women who were part of the US National Institutes of Health (NIH)-funded Women`s Health Initiative. At the beginning of the study, women were surveyed on health and lifestyle habits, as well as their household income and how far they had gone in school.

Every six months for the next eight years, a team led by Dr. Rashmee Shah from Cedars-Sinai Medical Center in Los Angeles checked women`s medical records to determine which of them were hospitalized for heart failure -- when the heart becomes far less efficient.

In total, there were 663 cases of heart failure, the researchers reported Monday in the Journal of the American College of Cardiology.

Each year, an average of 57 out of every 10,000 women with a household income of less than $20,000 per year were hospitalized with heart failure. That compared to only about 17 out of 10,000 women whose families made more than $50,000.

When the researchers accounted for race, underlying health factors and whether women smoked and drank, those in the lowest income bracket still had a 56 percent higher risk of heart failure than the wealthiest women. In addition, women that didn`t finish high school were 21 percent more likely to be hospitalized for the condition than college grads.


The researchers said that two key drivers of heart risks in poor women may be less access to preventive care and less communication with doctors and understanding of health risks.

Shah said that women`s neighbourhoods may play a role in their heart risks as well -- for example, whether or not it`s safe to walk outside and if there are grocery stores nearby.

With poor, older women, she said, "The big message here is that we are identifying an at-risk group that is growing."

Krumholz, who was not involved in the research, said the findings are a "challenge" to doctors to do a better job of treating underlying diseases such as high blood pressure in their poorer patients, and to stop heart disease before it happens.

"The risk factors for heart disease, in particular heart failure, are concentrated in certain groups in society, particularly those with low income," he said. "When early problems arise that could be intervened on, those aren`t addressed adequately."

Bureau Report

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