Heart Failure Alarmingly High Among Under-50 Blacks

Heart Failure Alarmingly High Among Under-50 African Ameicans

Heart disease in America, once thought to be the exclusive province of the elderly, is occurring more and more among younger age groups - and overwhelmingly among African Americans, according to a recent study that was the first large-scale effort to reveal the extent of the race gap in heart disease.

In the study, the scientists found that black adults in their 30s and 40s experience heart failure at a rate 20 times greater than their white counterparts. Fully one in 100 African Americans in this age group develop this condition – a rate similar to that among whites in their 50s and 60s.

“What these data point out is that it’s important to recognize that disease patterns differ in different populations,” said Kirsten Bibbins-Domingo, one of the study’s authors and co-director of the Center for Vulnerable Populations at the University of California at San Francisco, and San Francisco General Hospital. “We would have completely missed this at-risk group had we only been looking at older age groups. We would have also missed them if we had not been studying African Americans in large numbers.”

The government-funded study, which appeared in the New England Journal of Medicine, began in 1985 and included over 5,000 volunteers who were tracked over the course of 20 years with an eye on the development of heart disease among young adults. During the 20 years of the investigation, scientists measured participants’ blood pressure, weight, cholesterol, fasting blood sugar and kidney function six times.

The researchers found that African Americans who developed heart disease at younger ages exhibited at least one of four risk factors: high blood pressure, being overweight, low levels of “good” cholesterol (high-density lipoprotein, or HDL) and chronic kidney disease. Having one of the first three factors boosted heart disease risk by 40 percent to 100 percent, compared to African Americans without those factors. But having early-age chronic kidney disease increased risk by an astonishing 1,900 percent (20 times).

“Here we have tangible evidence that heart failure in the young is a real dilemma,” said Clyde Yancy, president-elect of the American Heart Association.

The study showed that a large proportion of young African Americans with high blood pressure (75 percent at the start of the study, and 57 percent 10 years later) don’t get appropriate medication, suggesting that, for some reason, this population is dramatically underserved. This means African Americans are more likely to develop additional heart disease risk factors, none of which are being treated assertively enough to protect this group from early illness.

“Our ability to intervene early and appropriately is limited,” said Yancy. “That is something that we need to change, because I think it’s a crisis.”