March 18, 2009 — One in 100 African-Americans will suffer
in
the prime of his or her life, a startling new study shows.
That’s 20 times white Americans’ risk of heart failure before age 50.
“Blacks in their 30s and 40s develop heart failure at rates seen in
whites in their 50s and 60s,” study leader Kirsten Bibbins-Domingo, MD,
PhD, of the University of California, San Francisco, tells WebMD.
Bibbins-Domingo and colleagues followed 5,115 young people — about half of
them African-American, about half of them female — who underwent regular
medical exams over the first 20 years of the ongoing study. Twenty-seven study
participants had heart failure at an average age of 39. All but one of them
were African-American.
Study participants were 18 to 30 years old — most in their early 20s –
when the study began in 1985-1986 in Birmingham, Ala.; Chicago; Minneapolis;
and Oakland, Calif.
“It has been known for some time that blacks have more heart failure and
may be slightly younger when they develop heart failure, but ours is the first
study to document how high these rates are at younger ages,”
Bibbins-Domingo says.
Interestingly, in terms of
risk, whites and African-Americans
looked pretty much the same at the start of the study. When participants were
in their early 20s, there was little difference in
.
“So why were only blacks developing heart failure in our study? One
possibility is blacks have higher rates of increases in blood pressure and BMI
in their 20s. Although at the beginning they were similar to whites, over time
the two groups began to look different, with more
and obesity
among blacks,” Bibbins-Domingo says.
A telling statistic: Three-fourths of the African-American study
participants who suffered heart failure had uncontrolled high blood pressure by
age 40.
Heart Disease Screening, Treatment Lax
Don’t blame the patient, warns Eric D. Peterson, MD, MPH, director of
cardiovascular research at Duke University.
In an editorial accompanying the Bibbins-Domingo report, Peterson notes that
African-American patients are less likely than whites to be screened for, get
treatment for, or reach treatment goals for high blood pressure, high
/blood fats, and obesity.
“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.”

webmd.com

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