LETTER
Social Class and Recovery from Myocardial Infarction
L. Julian Haywood, MD
15 April 1998 | Volume 128 Issue 8 | Pages 695-696
TO THE EDITOR:
The study by Ickovics and colleagues [1] clearly documents the independent effect of social class on functional outcome after myocardial infarction in men, and it documents that the effect of functional class is already present at baseline. This finding is consistent with our finding that the increased mortality and morbidity for black persons in the Beta-blocker Heart Attack Trial were associated with the larger constellation of risk factors at baseline [2]. Moreover, in later studies, we found that socioeconomic status was a clear influence on the health care-seeking behavior associated with suspected heart attacks [3, 4]. The authors should have commented briefly on the decision to exclude women from their study, because women had a higher overall risk in the Beta-blocker Heart Attack Trial.
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Author and Article Information
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Los Angeles County-University of Southern California Medical Center; Los Angeles, CA 90033
1. Ickovics JR, Viscoli CM, Horwitz RI. Functional recovery after myocardial infarction in men: the independent effects of social class. Ann Intern Med. 1997; 127:518-25.
2. Haywood LJ. Coronary heart disease mortality/morbidity and risk in blacks. I: Clinical manifestations and diagnostic criteria. The experience with the Beta-blocker Heart Attack Trial. Am Heart J. 1984; 108:787-93.
3. Ell K, Haywood LJ, Sobel E, deGuzman M, Blumfield D, Ning JP. Acute chest pain in African Americans: factors in the delay in seeking emergency care. Am J Public Health. 1994; 84:965-70.
4. Ell K, Haywood LJ, deGuzmann M, Sobel E, Norris S, Blumfield D, et al. Differential perceptions, behaviors and motivations among African Americans, Latinos and whites suspected of heart attacks in two hospital population. Journal of the Association for Academic Minority Physicians. 1995; 6:60-9.
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