Heart Disease in the Black Community
The Disproportionate Increase of Heart Disease in the Black Population
While rates of heart disease and coronary artery disease (CAD) are rising across all populations, the Black community is particularly affected. Let’s talk about why this is and what you can do to decrease your chances of developing heart disease or CAD.
-
30%
of Black people are more likely to die from heart disease than non-Hispanic Whites1
-
70%, 50%
Black men are 70% more likely to have heart failure than White men; Black women are 50% more likely than White women2
-
47%
of Black adults have been diagnosed with cardiovascular disease, compared to 36% of White adults2
-
2x
Black adults are twice as likely to be hospitalized for heart failure than White adults2
The CAD Comparison: What's Different?
Coronary artery disease (CAD) in the Black community presents some distinctive aspects compared to other ethnic groups:
1. Higher prevalence: Black Americans have higher rates of CAD compared to White Americans. This is partly due to genetics, socio-economic factors, and lifestyle3.
2. Earlier onset: CAD tends to develop earlier in Black people compared to other ethnic groups4.
3. Higher mortality rates: Black Americans are more likely to die from CAD compared to White Americans. This is influenced by various factors including delayed diagnosis, inequalities in access to healthcare, and differences in treatment outcomes5.
4. Risk factors: Risk factors for CAD are the same across all ethnic groups (e.g., high blood pressure, diabetes, obesity, smoking), but these factors may be more prevalent or more severe in the Black community due to genetics and socio-economic factors4.
5. Awareness and prevention: There has been a growing effort to increase awareness of CAD risk factors in the Black community and improve preventive measures, which includes promoting healthier lifestyles, regular screenings, and better management of chronic conditions like hypertension and diabetes6.
Signs and Symptoms of CAD
There are several symptoms of CAD – you may experience some or all of the following:
- Chest pain (angina) – Have you experienced a heaviness, tightness, pressure, aching, burning, numbness, fullness, squeezing, or a dull ache during or after physical exertion? The pain may radiate to the shoulder, arm, neck, back, or jaw7.
- Shortness of breath – Do you have trouble catching your breath when doing regular activities or laying down7?
- Fatigue – Do you constantly feel tired or weak7?
- Pain, numbness, or weakness in arms or legs – Are you having unusual feelings in your limbs8?
- Nausea or indigestion – Do you feel sick to your stomach or feel like you have heartburn8?
- Swelling (edema) – This is swelling in the legs, ankles, feet, stomach and neck9.
- Coughing – A persistent, unexplained cough could be a sign that fluid is building up in your lungs10.
- Reduced or low ejection fraction (EF) – EF is the measurement of blood your heart pumps with each beat. An EF below 50% is considered Low EF; normal EF is 50-70%11.
Black Women & CAD: It’s time to put your health first
Black women suffering from CAD may experience different or additional symptoms than Black men. As a result, women often dismiss their CAD symptoms simply as signs of stress, being out of shape, or getting older. It’s a big reason why heart disease is the #1 killer of women, regardless of ethnicity. Here’s what to look for:
- Sleep problems – Do you have trouble falling asleep and/or staying asleep12?
- Pain in the jaw, throat, or neck – This can be a sign of reduced blood flow to the heart12.
- Nausea, vomiting, and abdominal pain – Indigestion can be an often-overlooked symptom of CAD12.
- Shortness of breath – Do you have trouble catching your breath when doing regular activities or laying down12?
- Swelling (edema) – In the legs, ankles, feet, stomach and neck9.
- Coughing – A persistent, unexplained cough could be a sign that fluid is building up in your lungs10.
- Fatigue – Do you constantly feel tired or weak7?
- Reduced or low ejection fraction (EF) – EF is the measurement of blood your heart pumps with each beat. An EF below 50% is considered Low EF; normal EF is 50-70%11.
- Angina (chest pain) - Have you experienced a heaviness, tightness, pressure, aching, burning, numbness, fullness, squeezing or a dull ache? The pain may radiate to the shoulder, arm, neck, back or jaw12.
If you have one or more of the symptoms, you should speak with your primary care physician or cardiologist.
A Range of Treatment Options
Your physician may recommend a variety of treatment options depending on the severity of your CAD. The goal is to reduce your risk of complications, improve your overall heart health, and relieve your CAD-related symptoms, which may include chest pain, fatigue, and shortness of breath. Treatment options may include:
Lifestyle Changes
Adjustments to your daily life can greatly improve your heart health: eating healthier with a focus on heart-healthy foods, exercising regularly and quitting smoking13.
Medications
There are a range of medication types that can improve your heart health, including statins, blood thinners, beta-blockers, ACE inhibitors13.
Surgery
Your doctor may recommend a surgical procedure to help restore blood flow to the heart13.
Interventional Procedures
Your doctor may suggest a minimally invasive percutaneous coronary intervention (PCI) stenting to restore heart blood flow. For high-risk patients, Impella CP® with SmartAssist® might be used during the procedure14,15.
What is Protected PCI with Impella CP?
Protected PCI, or protected stenting, with Impella CP is a widely accepted procedure in which Impella CP, is used to temporarily assist the pumping function of the heart while the interventional cardiologist performs the stenting procedure.
What You Can Do to Lower Your Chance of Developing Heart Disease
While every person and every circumstance are unique, there are a few general things you can do to help lower your chance of developing heart diseases such as CAD16.
- Know your family history – having a family member with heart disease could mean you’re at increased risk of also developing the condition
- Get screened for heart diseases, which can help identify your risks and catch heart issues sooner
- Know the warning signs of heart disease, which include chest pain, fatigue, shortness of breath, irregular heart rhythms
- Be aware of pain or swelling in your leg, which can be a sign of a heart complication or a vascular problem
- Stay active – exercise can help increase blood flow and cardiac output
- Maintain a healthy weight and diet – excess weight can lead to high blood pressure, damaged arteries and can increase the burden on your heart
- Take medications as prescribed by your physician – these can help lower the risk of heart attack
What is considered a healthy weight for your height? Here’s a guide17.
While not always the case, individuals who maintain a healthy height-to-weight ratio can be less likely to be diagnosed with heart failure or CAD. Working towards and maintaining a healthy ratio could help reduce your chances of these heart conditions.
References
- University of Chicago Medicine. Heart disease and racial disparities. UChicago Medicine. Retrieved October 30, 2023, from https://www.uchicagomedicine.org/forefront/heart-and-vascular-articles/heart-disease-and-racial-disparities
- Cleveland Clinic. (2022). Heart disease risk: How race and ethnicity play a role. Cleveland Clinic. https://my.clevelandclinic.org/health/articles/23051-ethnicity-and-heart-disease
- (n.d.). Recognizing and tackling a persistent problem: Cardiovascular health inequities. PubMed Central. https://pmc.ncbi.nlm.nih.gov/articles/PMC7371547/#:~:text=their%20unique%20needs.-,Recognizing%20and%20Tackling%20a%20Persistent%20Problem,-Cardiovascular%20health%20inequities
- American Heart Association. (n.d.). Prevalence of cardiovascular risk factors and the early onset of cardiovascular disease in African Americans. Circulation. https://www.ahajournals.org/doi/10.1161/cir.0000000000000534#:~:text=The%20higher%20prevalence%20of%20traditional%20cardiovascular%20risk%20factors%20(eg%2C%20hypertension%2C%20diabetes%20mellitus%2C%20obesity%2C%20and%20atherosclerotic%20cardiovascular%20risk)%20underlies%20the%20relatively%20earlier%20age%20of%20onset%20of%20cardiovascular%20diseases%20among%20African%20Americans.
- American Heart Association. (n.d.). Cardiovascular health in African Americans: Risk factors and disparities. Circulation. https://www.ahajournals.org/doi/10.1161/cir.0000000000000534#:~:text=Across%20nearly%20every,race%20and%20ethnicity
- American Heart Association. (n.d.). Overcoming cardiovascular health barriers for African Americans. Circulation. https://www.ahajournals.org/doi/10.1161/cir.0000000000000534#:~:text=However%2C%20increased%20awareness%20and%20acknowledgement%20of%20these%20barriers%20have%20led%20to%20investment%20in%20strategies%20that%20work%20within%20the%20constraints%20of%20the%20environment%20to%20promote%20the%20cardiovascular%20health%20of%20African%20Americans.
- Mayo Clinic. (n.d.). Coronary artery disease symptoms and causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/coronary-artery-disease/symptoms-causes/syc-20350613#:~:text=Chest%20pain%2C%20called,feel%20unusually%20tired
- Mount Sinai Health System. (n.d.). What is coronary artery disease?. Mount Sinai. https://www.mountsinai.org/care/heart/services/coronary-disease/what-is#:~:text=Signs%20and%20Symptoms,Indigestion%2C%20nausea%2C%20vomiting
- University of Michigan Health. (n.d.). Coronary artery disease (CAD). University of Michigan. https://medicine.umich.edu/dept/cardiac-surgery/patient-information/adult-cardiac-surgery/adult-conditions-treatments/coronary-artery-disease-cad#:~:text=Heart%20failure%20also%20can%20cause%20swelling%20in%20your%20feet%2C%20ankles%2C%20legs%20and%20abdomen
- Cleveland Clinic. (n.d.). Persistent cough: It may be a sign of heart failure. Cleveland Clinic. https://health.clevelandclinic.org/persistent-cough-it-may-be-a-sign-of-heart-failure#:~:text=In%20heart%20failure%2C%20your%20heart%20muscle%20has%20dysfunction%20that%20might%20be%20due%20to%20weak%20contraction%20or%20stiffness.%20This%20can%20allow%20fluid%20to%20back%20up%20in%20your%20lungs%2C%20creating%20a%20condition%20called%20pulmonary%20edema.%20Your%20body%20coughs%20persistently%20in%20an%20effort%20to%20eliminate%20the%20excess%20fluid.
- EuroIntervention. (n.d.). PCI has no role in patients with heart failure and reduced ejection fraction: Pros and cons. EuroIntervention. https://eurointervention.pcronline.com/article/pci-has-no-role-in-patients-with-heart-failure-and-reduced-ejection-fraction-pros-and-cons#:~:text=Coronary%20artery%20disease%20is%20the,myocardial%20infarction%20and%20(reversible)%20hibernation
- National Heart, Lung, and Blood Institute. (n.d.). Coronary heart disease in women. NHLBI. https://www.nhlbi.nih.gov/health/coronary-heart-disease/women#:~:text=Mental%20stress%20is,lack%20of%20energy
- Centers for Disease Control and Prevention. (n.d.). Coronary artery disease (CAD): Symptoms and causes. CDC. https://www.cdc.gov/heart-disease/about/coronary-artery-disease.html#cdc_disease_basics_treatment-treatment-and-recovery
- Wollmuth, J., et al. (2022). Cardiac interventions for heart disease. Journal of the Society for Cardiovascular Angiography and Interventions, 1(5), 100350–100350. https://doi.org/10.1016/j.jscai.2022.100350
- O’Neill, E., et al. (2022). Cardiovascular health and interventions. American Heart Journal, 248, 139–149. https://doi.org/10.1016/j.ahj.2022.02.006
- Healthline. Heart disease in African Americans: Prevention. https://www.healthline.com/health/heart-disease/heart-disease-in-african-americans#prevention
- National Heart, Lung, and Blood Institute. (n.d.). BMI categories table. NHLBI. https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmi_tbl.htm
As with any medical treatment, individual results may vary. Only a physician can determine whether Impella is an option for High-Risk PCI and would be an appropriate course of treatment. There are potential risks including acute renal dysfunction, aortic valve injury, bleeding, cardiogenic shock, cerebral vascular accident/stroke, death, hemolysis, limb ischemia, myocardial infarction, renal failure, thrombocytopenia and cardiac or vascular injury (including ventricular perforation). These risks need to be discussed with your doctor and recovery takes time. The success of this procedure depends on many factors, including your physical condition and your body’s ability to tolerate the procedure. Use care in the selection of your doctors and hospital, based on their skill and experience.
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