Why do black women have a higher risk of death from heart disease than white women?

Among a group of women with symptoms of angina who were tested for a suspected coronary blockage, nearly 3 times as many black women as white women died of heart disease. The study determined whether differences in the women's angina symptoms could affect the risk of death in these two groups, and the researchers report their findings in Journal of Women's Health.

Jo-Ann Eastwood, PhD and a team of researchers from medical institutions across the U.S. found that for white women, the severity or type of anginal symptoms—whether typical chest pain or more atypical symptoms such as stomach pain—did not affect outcomes. However black women tended to have more atypical symptoms, a worse prognosis when diagnosed with heart disease, and a higher risk of related death.

In the article "Anginal Symptoms, Coronary Artery Disease, and Adverse Outcomes in Black and White Women: The NHLBI-Sponsored Women's Ischemia Syndrome Evaluation (WISE) Study," the authors conclude that these racial differences in symptom presentation for coronary artery disease may be a barrier to correct and timely diagnosis and an important contributor to poorer outcomes for black women.

"These results indicate that we need to raise awareness among women and their healthcare providers of racial differences in anginal symptom presentation in order to improve both diagnosis and outcomes," says Susan G. Kornstein, MD, Editor-in-Chief of Journal of Women's Health, Executive Director of the Virginia Commonwealth University Institute for Women's Health, Richmond, VA, and President of the Academy of Women's Health.