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    Why Are African-Americans at Greater Risk for Heart Disease?

    African-Americans are at higher risk for heart disease, yet they're less likely to get the care they need.

    African-Americans and Health Care continued...

    "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."

    Treating Heart Disease Risk Factors

    Drummond's father, who had health insurance but not a physician he would go to on a regular basis, provides a cautionary tale about why African-Americans must maintain a consistent relationship with a good doctor who knows their medical history and provides preventive care, screenings, and referrals to specialists.

    "He had a leaking valve, and it didn't get replaced as soon as it should have," Drummond says. "The doctor told us it should have been replaced six or seven years earlier. When he started having swelling in his legs and shortness of breath, that's when he went to the hospital." Doctors diagnosed the leaking valve and performed surgery, but "it was too late for him," Drummond says. He died a few weeks after his surgery.

    Besides a strong family history, Drummond has other risk factors for heart disease. She was diagnosed with high blood pressure at age 28 and with type 2 diabetes about five years ago. After years of unsuccessfully trying to control her blood pressure with diet and exercise, she now takes medications.

    She's under a doctor's regular care, and she stays fit and eats healthy foods. "I work hard. I go to the gym to help control my hypertension and diabetes. I take the meds, I watch my sodium intake, and I work at keeping my weight within normal range." So far, she says, she's avoided heart failure.

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