Sex and Race Disparities Found in ICD Use

Sex and Race Disparities Found in ICD Use


Wide racial and gender disparities exist in the use of implantable cardioverter-defibrillators (ICDs), according to two JAMA reports.

One, a study of some 230,000 Medicare beneficiaries, examined ICD use for primary or secondary prevention of sudden cardiac death. Researchers found that men were 3.2 times more likely than women to receive ICD therapy for primary prevention, and 2.4 times more likely for secondary prevention. There were no significant survival benefits in the primary-prevention cohort in the year following implantation.

The other study, of some 13,000 patients with heart failure, also found that women were less likely than men to receive ICDs and that black patients — both men and women — were less likely to get them.

An editorialist says that the results "highlight disturbing patterns of health care inequality." With regard to survival benefits, she writes that paradoxically the bad news may be for white men "who are undergoing a procedure that, for primary prevention, has not been shown to extend their lives."

JAMA article on sex differences (Free)

JAMA article on sex and race differences (Free abstract; full text requires subscription)

JAMA editorial (Subscription required)