Heart disease has haunted generations of Robin Drummond's family. "I have a
family history of
heart disease on both sides," says the 55-year-old African-American and
resident of Hammond, La. "I've had uncles, aunts, and grandparents who've died
heart attacks and heart disease, and two of my mother's brothers died four
months apart. One had a heart attack in church, and four months later, one had
a heart attack in the post office."
When Drummond's father succumbed to heart disease at age 50,
she was shaken. "Particularly when my dad died, I wanted to make sure that I
was OK," she says. In 2002, she went to her doctor for testing and learned that
her heart was mildly enlarged, placing her at risk for
heart failure. Drummond, a registered dietitian, took strenuous measures to
ward off trouble. But not all African-Americans are aware of the danger.
When Ramona Richman's older sister was diagnosed with high cholesterol, Richman wasn't worried about her own risk. The San Francisco Bay Area stay-at-home mom had her weight under control and assumed that her diet was healthy. So when her doctor broke the news that she, too, had high cholesterol, she was shocked. Her reading of 269 mg/dL was well over the desirable level of less than 200 mg/dL. "My sister had high cholesterol and went on medication, so I imagine that it's a genetic thing," Richman,...
In a startling 2009 study published in the New England
Journal of Medicine, researchers found that African-Americans have a much
higher incidence of heart failure than other races, and it develops at younger
ages. Heart failure means that the heart isn't able to pump blood as well as it
Before age 50, African-Americans' heart failure rate is 20
times higher than that of whites, according to the study. Four risk factors are
the strongest predictors of heart failure:
high blood pressure (also called hypertension), chronic
kidney disease, being
overweight, and having low levels of HDL, the "good"
cholesterol. Three-fourths of African-Americans who develop heart failure
blood pressure by age 40.
African-Americans and Health Care
To prevent heart failure and other heart disease, it's crucial
to treat risk factors successfully, says Anne L. Taylor, MD, a professor of
medicine at New York Presbyterian Hospital and vice dean of academic affairs at
Columbia University's College of Physicians and Surgeons. But, compared with
their white peers, African-Americans often have less access to health care, she
says. Not only are they less likely to visit a doctor and get routine
screenings, but they're less likely to be referred to specialists.
"African-Americans with heart failure are more likely to be
taken care of in a primary care practice," Taylor says, "even though the data
would suggest that the best care -- the care that decreases hospitalizations
and improves mortality rates -- happens in cardiologists' offices."
Further, some African-Americans "tend to see illness and disease as the main
reason for health care, so you don't go to the physician for preventive
medicine -- you go when you're sick," says Keith C. Ferdinand, MD, FACC, FAHA.
Ferdinand is a clinical professor in the cardiology division at Emory
University and chief science officer of the Association of Black Cardiologists.
"When are you sick? When you have symptoms:
chest pain, shortness of breath, swelling,
dizziness. By the time people manifest the signs and symptoms of
cardiovascular disease, they have already had that disease present for one,
two, or even three decades."