Effects of race on lipid-lowering management in hospitalized patients with coronary heart disease

The objective of this study was to determine the association between patient characteristics, specifically race, and the appropriate management of lipid-reducing therapy in patients with coronary heart disease (CHD) discharged from the hospital. Two hundred fifty-eight consecutive patients with diagnoses suggestive of CHD were identified in a large, inner-city university teaching hospital serving a predominantly indigent African American population. The outcome measure, suboptimal lipid management, evaluated the intensification of lipid-reducing therapy when indicated using the National Cholesterol Education Program guidelines for the low-density lipoprotein cholesterol goal. The overall rate of suboptimal lipid management was 48%. Black patients with CHD were significantly more likely to have suboptimal lipid management than nonblack patients by the time of hospital discharge (52.3% vs 16.7%, p = 0.021). The disparity in the clinical management of black patients with CHD may help explain the differential in health outcomes seen between black and white patients. (C) 2004 by Excerpta Medica, Inc.