To the Editor: In their article on racial differences in theoutcome of left ventricular dysfunction, Dries et al. (Feb.25 issue)1 conclude that "black patients with asymptomatic orsymptomatic left ventricular systolic dysfunction appear tobe at higher risk for progression of heart failure and for deaththan similarly treated white patients, even when adjustmentis made for differences in the severity and cause of heart failure,the management of heart failure, coexisting illnesses, and socioeconomicstatus." The authors speculate that physiologic differences,presumably genetically determined, account for the otherwiseunexplained differences in outcome.
Redelmeier, D. A., Schull, M. J., Hux, J. E., Tu, J. V., Ferris, L. E.
(2001). Problems for clinical judgement: 1. Eliciting an insightful history of present illness. CMAJ
164: 647-651
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Grima, J., Persaud, R., Woloshin, S., Schwartz, L. M., Welch, H. G.
(1999). Race, Sex, and Referral for Cardiac Catheterization. NEJM
341: 2021-2022
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