African Americans More Vulnerable to Heart Problems

By Richard Olstein, MD

Despite all the advances the medical community has made in the treatment of coronary heart disease, preventing the occurrence of heart attacks, strokes and other forms of vascular disease remains essential to our fight against this No. 1 killer in America. In this fight, a portion of our community remains particularly susceptible — African Americans.

African Americans have a higher chance of death if they suffer a heart attack compared to Caucasians. According to the U.S. Department of Health and Human Services, in 2007, African American men were 30 percent more likely to die from heart disease compared to Caucasians. The explanations for this disparity have not been discovered. What’s clear is that preventing heart disease is one’s best chance of living a longer and healthier life. The only way to prevent heart disease is to control or prevent the classic risk factors.  These controllable risk factors include high blood pressure, diabetes, high cholesterol and smoking.

High blood pressure, or hypertension, is nearly 1.5 times more common in the African American population. In addition to leading to heart attacks and strokes, hypertension increases your chance of developing heart failure, kidney failure and vision loss. The goal is to reduce your blood pressure to less than 140/90 mmHg. This can sometimes be accomplished with a low salt/sodium diet and exercise, but often requires medications. Medications that are often particularly effective in African Americans include diuretics, or “water pills,” and calcium channel blockers.

High blood sugar, or diabetes, is very common in African Americans. Having diabetes gives one the same risk of suffering a heart attack as a person who has previously had a heart attack. Lack of exercise, diets high in carbohydrates, and having a family member with diabetes all increase one’s chance of developing diabetes. Health care professionals monitor your blood sugar by checking the hemoglobin A1C level, with a goal of less than 7 percent. This can sometimes be accomplished with a low-carbohydrate diet and exercise, but often requires pills or even injections of insulin.

High cholesterol is another risk factor for the development of heart disease.  A diet that is high in fat, especially animal fats, as well as a family history of high cholesterol, increases your chances of developing high cholesterol.   Exercise, a diet low in animal fats, cheeses, trans fats, as well as being high in fruits and vegetables can lower your cholesterol. Many different medications can be used to treat high cholesterol, with statin drugs being the most common and effective.

Cigarette smoking, still too common in the African American population, is a dangerous risk factor for heart disease. In addition to causing heart attacks and strokes, cigarettes lead to many other diseases including emphysema and lung cancer. According to the U.S Department of Health and Human Services, between 2005-2007, 25 percent of African American adult men and 17 percent of African American adult women smoked cigarettes. The benefits of quitting smoking on heart disease are immediate and long lasting. Many resources exist to help one stop smoking including counseling, nicotine replacement therapy and medications.

Hopefully with the knowledge of risk factors for heart disease, African Americans can work towards preventing an illness in which they are disproportionally affected.

Richard Olstein, MD, is a cardiology fellow at Rush University Medical Center.

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