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Acute Coronary Syndrome pp 229–245Cite as

Acute Coronary Syndrome in African Americans and Hispanic Americans

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Among African Americans and Hispanics in the United States, coronary heart disease (CHD) is highly prevalent and is the single most frequent cause of myocardial infarction and death in that population [1]. However, multiple factors contribute to overall poorer care and worse outcomes among African Americans and Hispanics when compared with whites. These factors include difference in disease manifestation, socioeconomic status, access to care, patient perception of the health care system and of providers, attitudes of health care providers toward minority patients, therapeutic modalities and responses to treatment, and patient education.

Although race-specific CHD data are sparse among black and Hispanic persons, rates of death among African Americans are among the highest in the industrialized world. This may be due to the complexities of race as a health factor or to controversies regarding whether health issues should even be considered in terms of race, as race is inextricably linked with socio-economic status in the United States. Nevertheless, current data indicate that there are increasing disparities in cardiovascular health care among African Americans and Hispanics [1–3]. Compared with whites, African Americans are more likely to present with CHD at an earlier age, have higher out-of-hospital coronary death rates, and are more likely to have sudden cardiac death as the initial clinical presentation of CHD. Although the reasons for these differences are not well understood, it is possible that these health consequences are explained by significant heterogeneity in acute coronary syndrome manifestation among African Americans. A high prevalence of certain coronary risk factors, delays in identification and treatment of high-risk individuals, limited access to cardiovascular care, and lack of compliance and trust in the health care system appear to contribute to the burden of CHD among African Americans.

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Authors and Affiliations

  1. Department of Cardiology, St. Luke's-Roosevelt Hospital Center Columbia University College of Physicians and Surgeons, New York, NY, USA

    Tseday Sirak MD, MPH & Claude Simon MD, PhD, FACC

  2. Division of Cardiology, Department of Medicine, St. Luke's-Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, NY, USA

    Simbo Chiadika MD & Matthew Daka MD

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  1. Tseday Sirak MD, MPH
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  1. Cardiac Catheterization Laboratory and Interventional Cardiology, Department of Medicine, St. Luke's-Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, NY, USA

    Mun K. Hong MD

  2. Cardiac Care Unit, St. Luke's-Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, NY, USA

    Eyal Herzog MD, FACC

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Sirak, T., Chiadika, S., Daka, M., Simon, C. (2008). Acute Coronary Syndrome in African Americans and Hispanic Americans. In: Hong, M.K., Herzog, E. (eds) Acute Coronary Syndrome. Springer, London. https://doi.org/10.1007/978-1-84628-869-2_21

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