Best care 'not given to Asian heart patients'

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The Independent Online
ASIAN MEN and women received worse coronary treatment than Europeans although they are known to have a higher risk of heart disease and were more likely to have had a heart attack, according to a study.

Men and women of Indo-Asian origins were less likely to be given early admission to a coronary care unit and more likely to be admitted later in a more serious state. As a result, they were less likely to be given the effective 'clot busting' drugs which should be used quickly after an attack.

Dr Felix Burden, consultant in general medicine at Leicester General Hospital, who led the study into the treatment received by 211 Indian and 192 European patients, said the results were disturbing.

The details in the new edition of the Journal of the Royal College of Physicians of London found that an Indian who was admitted to the specialist unit was more likely to be found on examination to have had a full heart attack 'yet less likely to receive care comparable to that of his European counterpart'.

Dr Burden, a specialist in diabetes, a risk factor for heart disease, found that nearly half of the Indian patients had diabetes, 47 per cent compared to 14 per cent. Thirty- four per cent had a heart attack confirmed compared to 27 per cent of the European patients. Only 49 per cent of the Indian patients had thombolysis, treatment with clot dissolving drugs, compared to 80 per cent of the Europeans.

Indian patients were four times more likely to be diagnosed with 'non specific/non cardiac pain'. Dr Burden, suggested that 'communication difficulties' may account for wrong diagnoses, and he urged GPs to be more alert to the possibility of heart attack in Indian patients, especially those suffering from diabetes, which is relatively common in the Indo-Asian population.

Dr Burden said: 'The reasons for the differences we found in the care are not clear-cut. They may be more linguistic-philosophical problems. Someone who lives in a foreign country may be extra stoical and delay getting help. Or a person might wave their arms about because they are frightened and scared and then be accused of over-reacting. This may delay admission or they may not be admitted at all.'

In England, the death rate from coronary heart disease among Asian men and women is 40 per cent higher than the average. Smoking and diet were suspected but research has proved otherwise.

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