A new analysis of 366 cardiac patients shows sharp racial disparities in the causes of cardiomyopathy, revealing how social and structural factors shape who develops certain types of heart muscle disease and why.
The study reports that Black patients were significantly more likely to develop cardiomyopathy driven by conditions such as hypertension and obesity—diseases closely tied to chronic stress, environmental exposures, and barriers to preventive care. In contrast, white patients were more likely to present with ischemic cardiomyopathy, typically linked to coronary artery disease.
Age played a role, but race remained a powerful predictor even after accounting for sex and other variables. Younger patients (ages 40–65) had the highest rates of cardiomyopathy overall, yet racial differences persisted across all age groups. The study’s figures, including the etiology distribution charts on pages 3–4, show that Black patients disproportionately clustered in categories associated with long-term social determinants such as neighborhood disadvantage, limited access to early treatment, and higher burdens of metabolic disease.
Insurance also appeared to reflect structural inequities. Patients with public insurance or no insurance were more likely to present with nonischemic cardiomyopathy—conditions often diagnosed later or managed less effectively.
The authors conclude that racial and ethnic disparities “cannot be fully explained by biology,” emphasizing that the causes of cardiomyopathy are “deeply linked to social determinants of health.” They call for improved screening, earlier management of hypertension and diabetes, and targeted policies addressing the unequal conditions that contribute to heart damage long before patients enter a hospital.
See: “Racial, Sex, and Age Disparities in Cardiomyopathy Etiology: A Social Determinant Analysis of 366 Cardiac Patients” (October 29, 2025)
