Blacks Have High Heart Failure Risk
Study Reveals Racial Gap for Risk of Heart Failure in the Prime of Life
Heart Disease Screening, Treatment Lax continued...
"We have come to accept that there are care differences between African-American and white populations, but does it really matter? This study shows 20-fold higher rates of heart failure that could potentially have been avoidable. It is just striking," Peterson tells WebMD.
What makes the finding tragic, Peterson says, is that we have effective treatments for high blood pressure.
"It is not a question of needing new treatments, it is a question of getting these treatments to patients," he says. "If we did that, we could avoid many of these cases."
More Heart Disease Prevention Needed
Heart failure is only one deadly outcome of high blood pressure. There would be 7,670 fewer heart disease and stroke deaths each year if African-Americans' blood pressure was controlled as well as that of white Americans, according to a recent study by University of Rochester researcher Kevin Fiscella, MD, MPH.
"Huge numbers of African-Americans who develop heart failure are untreated, and even among those who are treated, blood pressure is not controlled," Fiscella tells WebMD. "That is a huge opportunity for beginning to make a dent in this extraordinarily high risk of heart failure."
Compounding the racial differences in blood pressure control is young age. Young people simply don't worry about their blood pressure. That can be a fatal mistake.
"If you think about heart failure as your engine wearing out, think of the damaging effect of high blood pressure over 20 years of your life," Peterson says. "These are young people who were considered to be well, yet they had this ticking time bomb of disease that would kill them."
Bibbins-Domingo, Peterson, and Fiscella all agree that the main take-home message from the study is the need for heart disease prevention.
"This is really about focusing on prevention: the lifestyle issues around moderating weight and decreasing salt intake," Bibbins-Domingo says. "Prevention is the key when talking about a very high-risk group."
And Fiscella says there's another message here as well.
"This shows the progress we have made in reducing health care disparities has been pretty dismal to date," he says.
The Bibbins-Domingo study and the Peterson editorial appear in the March 19 issue of the New England Journal of Medicine.