A new study by the National Heart, Lung, and Blood Institute (NIH) has found racial disparities in advanced heart failure treatment.
Research has showcased that black adults at advanced heart failure centres received potentially life-changing therapies, such as transplants and heart pumps, about half as often as white adults, which could be potentially due to racial bias.
“The lives disabled or lost are simply too many,” said Wendy C. Taddei-Peters, PhD, a study author and clinical trials project official within the Division of Cardiovascular Sciences at the National Heart, Lung, and Blood Institute (NHLBI). “An immediate step could be to require implicit bias training, particularly for transplant and VAD team members.”
The small National Institutes of Health-supported study published its findings in Circulation: Heart Failure.
Following patients needing advanced heart failure treatment
The researchers followed 377 patients receiving treatment at one of 21 centres in the United States and found that 62 of 277 white adults (22%) received a heart transplant or ventricular assist device (VAD), a mechanical device that pumps blood for the heart. Whereas, 11 of 100 black adults (11%) received these advanced heart failure treatment options.
This part of the study builds on the Registry Evaluation of Vital Information for VADs in Ambulatory Life (REVIVAL) study, which aims to understand advanced heart failure treatment.
Was a racial bias discovered?
The researchers controlled multiple factors, including disease severity, quality of life, and several social determinants of health or conditions within the environment where people live that can affect health outcomes. They did not find any associations between patients’ race and death rates. However, the researchers found that 18 black adults (18%) and 36 white adults (13%) died during the study.
The researchers found that advanced heart failure treatment preferences between the two groups were similar, yet being black was associated with a 55% reduced rate of receiving VAD or a heart transplant.
The researchers noted that the findings expand on their current understanding of racial disparities in advanced heart failure treatment. They added that the disparity in treatment that black and white patients received and the inability to explain this by other others suggest bias.
“The totality of the evidence suggests that we as heart failure providers are perpetuating current inequities,” said Thomas M. Cascino, M.D., the first study author and a clinical instructor in the Division of Cardiovascular Disease at the University of Michigan at Ann Arbor. “However, recognising disparities isn’t enough. As physicians and health care providers, we must find ways to create equitable change.”