It’s well established that African Americans experience worse health outcomes than whites. But now new findings published in the journal JACC: Cardiovascular Interventions show that Black people are at a greater risk of dying or suffering heart attacks than white Americans despite undergoing nonsurgery interventions, Medscape reports.

The inquiry focused on more than 22,000 patients from 10 randomized controlled trials. Participants were mostly white and included Black, Hispanic and Asian patients. Compared with white patients, Black and Hispanic patients were more likely to have more comorbidities and less likely to be male. Additionally, Black patients were younger than participants of other races.

After adjusting for several factors, scientists found that the risk of heart attack for Black patients following coronary angioplasty—a nonsurgical technique that uses a stent to restore blood flow to the heart—increased 45% at one year and 55% after five years, compared with white patients.

In addition, Black patients’ risk of death also doubled at one year, while their risk of major adverse cardiac events was elevated by 28% at five years.

Researchers suggested that several factors may play a role in the increased risk of heart attack and death for African Americans, including socioeconomic, genetic and environmental differences and treatment compliance rates.

“Improving health care and outcomes for minorities is essential, and we are hopeful that our work may help direct these efforts,” said Gregg W. Stone, MD, of the Icahn School of Medicine at Mount Sinai in New York City and the study’s senior author. “But this won’t happen without active, concerted efforts to promote change and opportunity, a task for government, regulators, payers, hospital administrators, physicians and all health care providers.”

Stone also called for better representation of minorities in clinical trials and noted that trust must also be cultivated to generate confidence in minority groups to enroll in these studies.

For related coverage, read “Is Race an Issue When People With Heart Failure Are Hospitalized?” and  “Pregnancy-Related Heart Failure More Acute Among Black Women.”