Blacks may benefit less from cardiac rehab

By Amy Norton

NEW YORK (Reuters Health) - While both black and white heart disease patients improve their outlook with cardiac rehabilitation, black patients may not gain as great a benefit, a new study suggests.

Cardiac rehab involves supervised exercise and lifestyle counseling designed to help heart disease patients lower their risk of future heart attacks and other complications.

But, like heart disease care in general, African Americans may not gain as much from cardiac rehab as white patients do, researchers report in the American Heart Journal.

Their study of 616 patients found that white patients generally made greater improvements in their physical fitness, weight, blood sugar and "bad" cholesterol levels compared with their black counterparts.

Black women, in particular, lagged behind in improvements.

That's not to say, however, that black patients do poorly with cardiac rehab, according to lead study author Dr. Bonnie K. Sanderson of the University of Alabama at Birmingham.

She emphasized the "good news" that study patients, regardless of race, significantly improved their heart risk factors.

"This message is especially important," she told Reuters Health, "because (cardiac rehabilitation) is vastly underused."

Despite the therapy's proven effectiveness, only about 20 percent of eligible heart disease patients go through cardiac rehab, Sanderson noted.

She and her colleagues based their findings on 616 patients who went through cardiac rehab at their center between 1996 and 2006. Typically, a patient had two or three sessions a week over three to four months.

All of the patients had coronary heart disease, and the majority had already suffered a heart attack or had an invasive procedure to treat blocked heart arteries.

In general, Sanderson's team found, cardiac rehab helped both black and white patients improve their risk factors for further heart complications.

But black patients, on average, made little progress when it came to body weight, waist circumference, blood sugar control (in those with diabetes), and levels of triglycerides, a type of blood fat.

In addition, white patients tended to make greater improvements when it came to exercise habits, fitness and LDL cholesterol levels.

The reasons for the racial disparity are unknown, according to the researchers. But the findings "provide fuel for new research questions," Sanderson said.

Much research on cardiac rehab has centered on white men, she noted. More studies, Sanderson said, are needed to see whether, and why, other groups of patients -- whether minorities, women or the elderly -- fare differently after cardiac rehab.

SOURCE: American Heart Journal, June 2007.