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Friday, 1 March, 2002, 01:48 GMT
Ethnic divide in heart surgery
Asian women
Fewer Asian people have heart operations
South Asian patients are less likely to receive treatment for coronary artery disease than white patients , research suggests.

Researchers in London compared treatment rates in 502 south Asian and 2,974 white patients with heart disease.

The same proportion of south Asian and white patients were deemed appropriate to undergo treatment.

However, the south Asian patients were less likely to receive it than white patients.

The procedures that the researchers examined are designed to restore blood supply to the heart, and are known collectively as coronary revascularisation.

There are two forms:

  • coronary artery bypass grafts: in which veins from elsewhere in the body are used to replace blocked up coronary arteries
  • angioplasty: the use of balloon-type device to expand the width of the coronary arteries
The researchers, from Queen Mary's School of Medicine and Dentistry say the difference cannot be explained by bias from doctors or the socioeconomic status of patients.

Understanding

They suggest that south Asian and white patients may differ in their understanding of the risks and benefits of the procedure.

The administrative system, through which revascularisation is provided, involves written communications in English, long waiting lists and repeated outpatient assessments.

The National Service Framework for coronary heart disease in England and Wales explicitly that all ethnic groups get the same access to revascularisation.

Qaim Zaidi, ethnic strategy co-ordinator at the British Heart Foundation, said the research reinforced previous studies which have highlighted alleged inequalities in healthcare among ethnic communities in Britain.

Death rate falling

"Anecdotal evidence also suggests that a number of factors, such as language and cultural barriers and a failure to keep appointments, could mean that some South Asian patients are in danger of not being referred for the most appropriate treatment.

"More research is urgently needed to find out why this situation might be occurring.

"New evidence could then help empower patients from ethnic minorities and encourage them to demand faster access to treatment."

BHF statistics published 15 months ago showed that early deaths from coronary heart disease among Indians, Bangladeshis, Pakistanis and Sri Lankans are around 50% higher than the UK average.

And, although the death rate among South Asians is falling, it is falling more slowly - particularly among women.

The research is published in the British Medical Journal.


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