Department of Medicine, University of Chicago, IL.

BACKGROUND: Differences between blacks and whites have been reported in the incidence of several forms of cardiovascular disease, including hypertension and stroke. We examined racial differences in the incidence of cardiac arrest in a large urban population and in subsequent survival.
METHODS:We collected data on all nontraumatic, out-of-hospital cardiac arrests in Chicago
from January 1, 1987, through December 31, 1988, and compared the incidence and survival rates for blacks and whites. We examined the association between survival and race and seven other known risk factors by logistic-regression analysis. We computed incidence rates by coupling our data with U.S. Census population data.
RESULTS: Our study population comprised 6451 patients: 3207 whites, 2910 blacks, and 334 persons of other races. The incidence of cardiac arrest was significantly higher for blacks than for whites in every age group. The survival rate after cardiac arrest was 2.6 percent in whites, as compared with 0.8 percent in blacks (P < 0.001). Blacks were significantly less likely to have a witnessed cardiac arrest, bystander-initiated cardiopulmonary resuscitation, or a "favorable" initial rhythm or to be admitted to the hospital. When they were admitted, blacks were half as likely to survive. The association between race and survival persisted even when other recognized risk factors were taken into account. We did not find important differences between blacks and whites in the response times of the emergency medical services.
CONCLUSIONS:The black community in our study was at higher risk for cardiac arrest and subsequent death than the white community, even after we controlled for other variables.

PMID: 8341333 [PubMed - indexed for MEDLINE]

N Engl J Med 1993 Aug 26;329(9):656-8
Comment on:
      N Engl J Med. 1993 Aug 26;329(9):600-6.
      N Engl J Med. 1993 Aug 26;329(9):621-7.
Heart disease in black and white.
Ayanian JZ.

Publication Types: Comment; Editorial
PMID: 8341342 [PubMed - indexed for MEDLINE]

N Engl J Med 1994 Jan 20;330(3):216-7; discussion 217-8
Comment on:
      N Engl J Med. 1993 Aug 26;329(9):600-6.
Heart disease and race.
Rodney E, Vasavada BC, Sacchi TJ.

Publication Types: Comment; Letter
PMID: 8264753 [PubMed - indexed for MEDLINE]

N Engl J Med 1994 Jan 20;330(3):216; discussion 217-8
Comment on:
      N Engl J Med. 1993 Aug 26;329(9):600-6.
Heart disease and race.
Lai S, Page JB.

Publication Types: Comment; Letter
PMID: 8264752 [PubMed - indexed for MEDLINE]

N Engl J Med 1994 Jan 20;330(3):217; discussion 217-8
Comment on:
      N Engl J Med. 1993 Aug 26;329(9):600-6.
Heart disease and race.
Platt FW.

Publication Types: Comment, Letter
PMID: 8264754 [PubMed - indexed for MEDLINE]