Heart Disease, a Common Reality for Young African Americans

A recent study published in the American Journal of Medicine found that African Americans between the ages of 35 and 44 had nearly twice the prevalence of cardiovascular disease — a history of heart attack, heart failure or stroke – than their white counterparts enrolled in the study.

By Karen Roberts

Elizabeth Webb, who is African American, was just 27 years old when she first learned of her heart problems. Webb suffered from nosebleeds and was eventually diagnosed with hypertension and heart disease.

“I was devastated,” says Webb, who is now 51 years-old. “When you’re young you don’t think anything can happen to you.”

It has been clinically known that blacks suffer from heart failure at higher rates and develop heart failure at younger ages.

A new study published in the American Journal of Medicine found that African Americans between the ages of 35 and 44 had nearly twice the prevalence of cardiovascular disease — a history of heart attack, heart failure or stroke – than their white counterparts enrolled in the study.

The results led researchers at the Cleveland Clinic Medicine Institute in Ohio to predict that just under 2 % of white adults in that age group had ever been diagnosed with cardiovascular disease, versus just under 4% of African Americans.

The study builds on noted findings reported last year in the New England Journal of Medicine. That study, led by researchers at the of the University of California, San Francisco, was the first to quantify the disparity, finding significant differences in the rate in which blacks are impacted by the disease.

In that study researchers predicted that one in 100 black adults will develop heart failure in their 30s or 40’s, a rate that is 20 times higher than that of white adults.

“When you think about it, young people in their 20s and 30s are making money and raising families,” says Kirsten Bibbins-Domingo, an epidemiologist at the University of California, San Francisco and the study’s lead author. “This most important group is being destroyed at the core.”

Bibbins-Domingo and her colleagues enrolled more 5,100 people aged 18-30 into the study and followed them for 20 years. The participants, who volunteered in such cities as Chicago, Minneapolis and Oakland, were tested for weight, cholesterol, blood pressure, kidney and other heart disease risk factors. Of the participants followed, 27 developed heart failure at an average age of 39. All but one of the patients were black.

The U.S. Department of Health & Human Services says African-American adults are less likely to be diagnosed with coronary heart disease, but are more likely to die from heart disease. What’s more, African-American adults are 40% more likely to have high blood pressure, but are 10% less likely than their non-Hispanic or white counterparts to have their blood pressure under control.

The study, which was funded by the U.S. National Institutes of Health, also examined several causes of heart disease, including smoking, obesity, a high salt and fat diet, and high blood pressure, which the researchers cited as a powerful risk factor for the condition.

Combating heart disease is a three part process that involves awareness, treatment and control. “The striking thing for me is this group is the least likely to know about high blood pressure and least likely to do anything about it, “Bibbins-Domingo says.

The University of San Francisco study isn’t the first to find the link between blacks and heart failure, but it is the first to uncover how early risk factors can be more prevalent in blacks, compared to whites.

Heath experts say the main culprit is diet – a high calorie, fat and salt laden pattern of eating will result in an unhealthy heart. Many African Americans eat double or triple the recommended daily salt intake. Much of their salt allotment is used up with packaged and processed foods, which are linked to high blood pressure.

Dr. Bibbins-Domingo says her study did not specifically answer why blacks were more susceptible than whites to heart disease. However, she says preventing such risk factors as high blood pressure could be the key to combating heart disease.

“The good news is we know how to prevent high blood pressure and it is the most important thing to solve this puzzle,” she says.

Encouraging Lifestyle Changes

Following her diagnosis nine years ago at age 42 with cardio myopathy and congestive heart failure, Elizabeth Webb changed her diet and sought out opportunities to walk more, evening giving up her parking space. “I was walking more, never realizing the simple things that can make a big difference in my life,” says Webb, a New York City resident.

Webb’s lifestyle change paid off. She lost 100 pounds and is hoping to lose even more weight. But her heart troubles aren’t over yet as Webb recently faced a third heart surgery. “Not knowing what you’re dealing with is kind of hard,” she says.

Over the years, Webb say there wasn’t much discussion with family about their various heart conditions. “In my family there was never talk about family health history, it was always ‘she had an enlarged heart or something,’ nothing specific.”

Getting blacks to speak more openly about their heart health is one of the goals of the Black Barbershop Health Outreach Program, a grassroots organization that offers blood pressure screenings and other heart disease information at barbershops across the U.S. A goal of the program is to screen 500,000 people for high blood pressure by 2012.

Dr. Bill Releford started the Oakland based organization to help African-American men learn more about heart disease. With a practicing specialty in diabetic lymph amputation, Releford knows first hand about serious health ailments.

“In every city we’ve visited we have had to take at least one person to the emergency room,” he says. “I’ve seen men in their 20s, 30s and 40s with blood pressure readings too high to register.”

Releford says he’s not surprised by the data showing a higher prevalence of heart disease in young African-Americans. He says this study could lead to subsequent research that identifies solutions to the barriers to accessing health care and why many blacks aren’t getting the care they need.

“The study gives us the documentation that we are in a health care tsunami, and helps us go to our elected officials for funding,” Dr. Releford says.

Symptoms of Heart Failure

-shortness of breath

-weight gain

-swelling of the hands and feet

-fatigue

-abdominal pain

-chest pain or discomfort

Preventing Heart Disease

-prevent and control high blood pressure and high cholesterol

-maintain a healthy weight

-prevent and control diabetes

-quit smoking

-regular physical activity

-practice good diet and nutrition