More blacks die of heart disease

Death rates higher by startling amount for men and women

Health & Fitness

May 05, 2002|By Jane E. Allan | Jane E. Allan,Special to the Sun

Blacks in the United States are more likely than whites to die of heart disease -- and at a younger age -- and yet no one can say precisely why.

Although earlier diagnosis and improved treatment have contributed to an overall decline in U.S. death rates from cardiovascular illnesses during the past 30 years, blacks haven't shared in those improvements. They continue to suffer high rates of potentially fatal cardiovascular diseases such as hypertension and stroke. Black men are twice as likely as white men to die of heart disease before their 65th birthday.

Scientists have been aware of the growing problem of heart disease among black Americans for 30 years, but they have had little evidence to help explain it and find better ways to target prevention and therapies.

Now researchers are embarking on the largest population study of this overlooked group. The $33 million project, sponsored by the National Institutes of Health, represents the federal government's recognition of an "unchecked epidemic of cardiovascular disease in the African-American population," said Dr. Herman Taylor, director of the Jackson Heart Study.

The study is taking place in Mississippi, where blacks die more often of heart disease than any state in the nation. Cardiac death rates for Mississippi blacks are higher than they were in 1980.

Most of what scientists know about the cardiac risk factors of smoking, high blood pressure, high cholesterol and diabetes comes from the landmark Framingham Heart Study, a continuing project that has tracked men and women living in Framingham, Mass., a predominantly white Boston suburb.

Begun in 1948, the Framingham study was a product of its times, when there was a perception "that African-Americans were not as vulnerable to [heart disease] as the rest of the population," Taylor said.

Information from death certificates at the time seemed to bear out the belief that white men were the most frequent victims of heart attacks.

As doctors' knowledge of heart disease has grown in recent years, they've come to better understand the subtle differences associated with gender, race and nationality. Doctors now know, for instance, that women's heart attack symptoms are different from men's, and that people living in Japan have different rates of heart disease compared to Japanese living in Hawaii or the U.S. mainland.

In the 1970s, blacks began dying at a greater rate from heart attacks than whites. Yet despite warning signs of a burgeoning public health problem, no one undertook a large-scale study to pinpoint how blacks might be uniquely affected by race, culture, economic status and other factors.

Before the launching of the Jackson study, Taylor, a Harvard-trained cardiologist, said that whenever he attended national meetings of black physicians there would be talk about the need for a "black Framingham."

Doctors, he said, suspected that diet, poor access to medical care and inadequate health insurance were contributing risk factors, but they also were interested in genetic underpinnings and environmental influences such as stress and discrimination.

Eventually, the NIH's National Heart, Lung and Blood Institute became the lead sponsor of the Jackson Heart Study, launched in 2000 at the University of Mississippi Medical Center and two predominantly black schools, Jackson State University and Tougaloo College.

So far, researchers have signed up 1,700 of the 6,500 blacks between the ages of 35 and 84 they hope to recruit. Their goal is to tear apart how much each of the various risk factors contributes to coronary artery disease, heart attacks, congestive heart failure and strokes, and at the same time, train more blacks for careers in minority health research.

While still expecting to reach their enrollment goals, the researchers note that they have had to overcome a great deal of reluctance among blacks to participate in clinical studies. Those feelings stem in large part from the Tuskegee scandal in Alabama, where from 1932 to 1972, poor black men suffering from syphilis were deceived by doctors and nurses who claimed to be treating them, but instead used them to chart the course of unchecked disease.

But the Jackson Heart Study is beginning to catch up with aggressive community outreach, said Sonja Fuqua, director of recruitment, who added that a big selling point is that participants "are getting $4,000 of free medical care."

Jane E. Allen is a reporter for the Los Angeles Times, a Tribune Publishing newspaper.

Heart disease deaths

Black men and women in the United States have higher death rates from heart disease than whites. Below are the average annual deaths per 100,000 people for the years 1994-1998.

......................Black ............White ........Black ..............White

Ages.............. Men .............. Men ........ Women ........... Women

35-44 ............86.9 .............. 40.5 ........ 45.8 ................. 13

45-54 ........... 300.6 ............149.4 ......... 140 ............... 45.6

55-64 ........... 733.3 ........... 425.9 ........ 378 ............... 166.2

65-74 ......... 1,397.1 ........ 1,048.5 ...... 898.8 ............. 514.5

75-84 .......... 2,758 ..........2,525.4 ........2,097.7 ......... 1,641.2

Source: Centers for Disease Control and Prevention

Baltimore Sun Articles
|
|
|
Please note the green-lined linked article text has been applied commercially without any involvement from our newsroom editors, reporters or any other editorial staff.