Poor Suffer More After Heart Attacks, Israeli Researchers Find

Study findings could help doctors and policymakers improve post-heart-attack care for the poor.

Poor people may suffer more than their wealthy counterparts following a heart attack, researchers at Tel Aviv University say.

In a study published in the International Journal of Cardiology, Tel Aviv University Sackler Faculty of Medicine researchers Vicki Myers and Prof. Yariv Gerber found that the risk of becoming what they call "clinically frail" after a heart attack is twice as high for people of lower socioeconomic sectors.

The findings could help doctors and policymakers improve post-attack care for the poor, the researchers said in a statement.

"By defining frailty, which combines many areas of medicine, we can predict which people are at the highest risk after a heart attack," said Ms. Myers in a statement. "And we found a strong connection between frailty and socioeconomic status."

The researchers worked with 1,151 Israelis who had experienced a heart attack 10 to 13 years prior to the beginning of the study. They applied an index of 40 health variables – including such factors as energy levels, health problems and diseases, physical inactivity, weight loss and health deterioration – to determine the participants' frailty.

The researchers found that 35 percent of their study subjects had become frail in the decade following their heart attack. Those frail patients were more likely to have suffered a severe heart attack and to have been older and obese when they were first evaluated. In addition, they were more likely to have been members of lower socioeconomic classes, less educated and earn lower incomes.

Despite this, the frail patients were less likely to have been admitted to intensive care, have had surgery or been prescribed medications commonly prescribed after a heart attack – all of which the researchers say may reflect lesser access to health care among the poor.

"Not only was low income associated with twice the risk of becoming frail, living in a deprived neighborhood was linked to a 60 percent increased risk of frailty compared to living in a wealthy neighborhood, irrespective of personal circumstances," Myers said.