Heart disease is the leading cause of death for all adults in the U.S. But for Black and Hispanic people, the risk is even higher than it is for white people.
The reasons are complex, but the most common ones include:
- Biological factors
- Lack of treatment access
- Higher burden of other medical conditions
- Communication and language barriers
- Medical stigma and distrust
- Bias and racism in the health care system
A Look at the Numbers
No matter what the cause, the numbers are clear. Black men are 70% more likely to develop heart failure than white men. For Black women, the risk is 50% higher than it is for white women. In fact, black women are more likely to have heart failure than adults of any other race or sex in the U.S. Black people of both sexes are admitted to the hospital for heart failure twice as often as white people. Once in the hospital, black people spend twice as much time there, and they are more likely to come back again.
In the last 10 years, the rates of hospitalization for heart failure have gone down overall, but the disparities between Black adults and white adults has stayed the same.
As for Hispanic adults, they are more likely than white adults to have heart failure. And they typically get it at a younger age.
Conditions That Raise Heart Failure Risk
High blood pressure (hypertension) is a major risk factor for heart disease. Over time, high blood pressure can permanently damage the heart. Black Americans have the highest rates of high blood pressure in the world. They’re also most likely to have a stroke, and at a younger age, than people in other racial or ethnic groups.
Overweight and obesity – risk factors for heart failure – affect Black people disproportionately, too. In the Black community, nearly 7 in 10 men and more than 8 in 10 women are overweight or obese. Compare that to the population at large where 3 in 10 adults are overweight.
Looking at Latin Americans, Mexican-American adults in particular are more likely than white adults to have a stroke. Hispanic adults of all backgrounds are more likely than white people to have diabetes and high blood pressure and to be overweight or obese -- all risk factors for heart disease.
Hispanic and Black adults are more likely than white adults to develop diabetes. Hispanic women in particular are more than twice as likely as white women to have diabetes. This condition raises your risk of heart failure by a lot. People with type 2 diabetes are two to four times more likely to have heart failure than people without diabetes.
Your Genes and Your Heart Failure Risk
Research shows that some genes commonly found in Black and Hispanic populations may play a role in the increased risk of heart failure.
One study found a gene in people of African or Latino ancestry that deposits abnormal proteins in several organs including the heart. People with this variant are twice as likely to have heart failure.
People in the Black community may also carry a gene that makes them more sensitive to salt. This gene doesn’t directly raise heart failure risk, but it makes you more prone to two risk factors for heart failure: high blood pressure and heart disease.
Social and Economic Factors
Another important piece of the puzzle when it comes to differences in heart failure risk across race and ethnicity is social and economic factors. Health professionals sometimes call these factors “social determinants of health.”
Simply put, when people have access to these basic resources, their health tends to be better. When they don’t have these resources, they might be at higher risk for many health problems, including heart failure.
For Black and Hispanic communities, access to the following resources can be more difficult than it is for people in white communities:
- Money and resources for life’s basic needs
- Quality education
- Quality health care
- Clean air and water
- Fresh fruits and vegetables
- Safe living environment
Access to Care
Whether you get a fast and accurate diagnosis for numerous health conditions depends in part on the color of your skin. In studies, Black men are the least likely of any group to see a cardiologist during hospitalization for heart failure.
When it comes to treatments to help manage and prevent heart failure, minorities get less than 40% of advanced heart failure therapies, heart transplants, and devices that help pump blood through the heart (ventricular assistive devices) every year.
Despite their high risk of heart disease, very few Hispanic men and women know what their cholesterol is or get screened at the doctor.
What You Can Do
Despite your elevated risk, you can empower yourself and take control of your heart health. Here’s a few steps you can take:
- Talk to your doctor about your individual risk, which factors you can control, and which ones you can’t.
- Learn your family history of heart disease and share this with your doctor.
- Get regular checkups on your blood pressure, cholesterol, and blood sugar, no matter your age.
- Explore ways to lower or manage your stress, such as exercise, meditation, socializing, or “me time.”
- Enroll in clinical trials
A Word About Clinical Trials
Clinical trials are research studies that include real people and help doctors and scientists make discoveries about diseases and treatments for them. Even though the risk of heart failure in Black and Hispanic people is greater than in white people, you’ll find far more white people in clinical trials. This causes several problems. For one, doctors and researchers learn less about health issues of Black and Hispanic people. Also, discoveries about treatments and prevention made in mostly white clinical trials may not apply to Black and Hispanic people.
Talk to your doctor or visit ClinicalTrials.gov to see if there is a clinical trial you can participate in to increase data on minority populations who live with increased risk of heart failure.
Photo Credit: Courtney Hale / Getty Images
CDC: “Leading Causes of Death.”
News release, Mount Sinai.
American College of Cardiology: “Latest Evidence on Racial Inequities and Biases in Advanced Heart Failure.”
Cleveland Clinic: “How Race and Ethnicity Impact Heart Disease.”
Stony Brook University Renaissance School of Medicine: “Cardiovascular Disease in Hispanics/Latinos in the United States and on Long Island.”
Circulation: Heart Failure: “Understanding the Complexity of Heart Failure Risk and Treatment in Black Patients.”
American Heart Association: “African Americans and Heart Disease, Stroke,” “Diabetes and heart failure are linked; treatment should be too.”
Current Opinion in Cardiology: “Representation of Black patients in heart failure clinical trials.”