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.