Young Black Adults Twice as Likely to Die in First Year After Heart Transplant

Young Black adults who receive heart transplants are more than twice as likely as their non-Black peers to die within a year, new research shows.

The higher risk of death begins to decline after the age of 30, with racial disparities among heart transplant recipients disappearing by age 61, the study found. The work is published in the American Heart Association journal Circulation: Heart Failure.

While previous research has consistently revealed a gap in mortality rates for Black and non-Black heart transplant recipients, this was the first study to show the disparity was most striking among younger adults.

"Generally, older patients are at a higher risk of having worse outcomes following a major procedure," said senior study author Errol L. Bush, MD, in a news release. Bush is an associate professor of surgery and surgical director of the Advanced Lung Disease and Lung Transplantation program at Johns Hopkins University in Baltimore.

The findings further highlight the disproportionate level of heart health problems among young Black adults and the need for greater attention to this group, the researchers concluded.

"Our findings indicate clinical research moving forward should focus on targeted interventions for young Black recipients during this high-risk period so that long-standing racial disparities seen in heart transplant survival can be improved," said Hasina Maredia, MD, in the release. Maredia led the study as a medical student at Johns Hopkins University.

In the study, researchers compared mortality rates for 23,000 heart transplant recipients in four age groups. They found a 30% higher risk of death for Black adults across all ages compared with non-Black heart transplant recipients. The gap in mortality rates was highest for those under 30, who were twice as likely overall to die—and 2.3 times more likely to die within the first year after their heart transplant. Those aged 31 to 40 were 1.5 times as likely to die. By age 61, the mortality gap was no longer statistically significant.

The study also found young Black heart transplant recipients were more likely to have diabetes, high blood pressure, or both; have a weakened heart muscle; and be insured by Medicaid rather than a private insurer. Prior research shows Black adults more frequently have heart disease at younger ages and are therefore more likely to need heart transplants at a younger age than their non-Black peers.

"The high risk associated with Black race is not specifically due to race itself," Bush said. "It is a marker of systemic racism and inequities that have resulted in health care disparities."

— Source: American Heart Association