Young African-Americans are 20 times as likely as whites to develop heart failure, according to a new study published today. The deadly illness strikes one in every 100 blacks under the age of 50.
"We usually thought of heart failure as a disease of older people, but that's based on studies by mostly white participants," said Dr. Kirsten Bibbins-Domingo, an assistant professor at the University of California, San Francisco and the study's lead author. "The rates we're seeing of blacks in their 30s and 40s are similar to the rates you will see of whites in their 60s and 70s."
Researchers and cardiology specialists called the findings alarming and a call to action. The scientific community should step up its research on the risk factors and design clinical trials to study specialized treatment for black patients, they said.
The findings also should come as a wake-up call to young African-Americans to eat healthier and exercise. And health officials should launch prevention and education efforts as early as high school, they said.
"It's scary," said Dr. Mandeep R. Mehra, chief of cardiology at the University of Maryland Medical Center. "I think one could describe this in many ways as an epidemic in the young African-American patient, and really, it calls for structured health care efforts in the patient."
While medical experts have known for years of racial disparities in cardiac illnesses, researchers say this study is the first to examine young people with heart failure, in which a weakened heart can't pump blood to all the places in the body that need it.
The data do not reveal why blacks are more likely to develop heart failure. Experts believe genetic differences, blacks' higher rates of hypertension and obesity, and lack of access to health care all play a role. But they say more research is needed to pinpoint the causes of the disparity and develop methods to attack it.
The findings, published in the New England Journal of Medicine, come from an analysis of a 20-year study of 5,115 black and white men and women under 50. The Coronary Artery Risk Development in Young Adults Study began in 1985 with healthy participants between the ages of 18 and 30 recruited from four sites across the country. It was conducted by the National Heart, Lung and Blood Institute, a division of the National Institutes of Health.
By the end of the study, 27 men and women had developed heart failure; all but one was black. Five of the black patients had died.
