Heart disease: dealing with the biggest killer - Annual Black Health & Fitness Section

Ebony, July, 2002 by Kevin Chappell

ONE is the No. 1 single cause of death to Blacks in the United States. The other is No. 3. Together, the twin assassins of heart disease and stroke kill 9,000 Blacks every month--more deaths to African-Americans than all other diseases combined.

But as devastating as cardiovascular disease is, research has shown that Blacks are actually more afraid of cancer and AIDS than heart disease. And most Black women believe that breast cancer (which kills 1 in 25 women) is their greatest health risk, although heart disease and stroke claim 1 in every 2 women.

In fact, the disparities in heart disease are widest for African-American women, who have a 69 percent higher death rate than White women. The reasons for the disparities include a higher prevalence of hypertension, diabetes and obesity among Black women.

But there is good news. Doctors say the risk of having a heart attack--even in people who already have coronary heart disease or have had a previous heart attack--can be reduced by preventing or controlling certain risk factors.

One of the greatest risks is smoking. Cigarettes greatly increase the risk of fatal and nonfatal heart attacks in both men and women. Smoking also increases the risk of a second heart attack among survivors. Women who smoke and use oral contraceptives have an even greater risk than smoking alone.

The good news is that quitting smoking greatly reduces the risk of heart attack. One year after quitting, the risk of having a heart attack drops to about one-half that of current smokers and gradually returns to normal in people without heart disease. Even among people with heart disease, the risk also drops sharply one year after quitting smoking and it continues to decline.

Another factor that increases the risk of heart attack is high blood pressure. Also called hypertension, high blood pressure makes the heart work harder than it should. Although it has no symptoms, hypertension is the most common form of cardiovascular disease. Two out of every three Blacks will develop hypertension by the time they are 60. Those who have high blood pressure have an 80 percent higher stroke mortality rate, a 50 percent higher heart disease mortality rate and a 320 percent greater rate of kidney disease than in the general population.

On Capitol Hill recently, Rep. Donna Christian-Christensen, D-V.I., of the Congressional Black Caucus teamed up with Dr. Richard Allen Williams, founder of the Association of Black Cardiologists, and NFL Hall-of-Famer Deacon Jones to challenge African-Americans to take control of their blood pressure.

Called "State of the Heart," the initiative is in response to a recent survey by the National Hypertension Association, which found low awareness among Blacks of the risks associated with high blood pressure. The survey of 3,500 African-American adults found that one-third didn't know their blood pressure levels, one-half didn't know the risk factors associated with high blood pressure and nearly 85 percent didn't know that weight loss could help lower blood pressure.

"Health care issues are at the forefront of the [Black Caucus'] 2002 agenda, says Christian-Christensen, chair of the Health Braintrust of the Congressional Black Caucus. She says the Caucus is committed to cardiovascular disease research and education and that State of the Heart is one element of an overall campaign to reduce health care disparities in the United States. "By encouraging African-Americans to take control of their blood pressure through regular monitoring, we hope to reduce this dangerous problem within our communities."

Blood pressure is recorded as two numbers--the systolic pressure (as the heart beats) over the diastolic pressure (as the heart relaxes). For example, a measurement would be written as 120/80 mm Hg (millimeters of mercury). Normal blood pressure is less than 130 systolic and less than 85 diastolic. An optimal blood pressure is less than 120 mm and less than 80 diastolic. A consistent blood pressure reading of 140/90 or higher is considered high blood pressure.

"We have a lot of work to do," says Dr. Williams. "African-Americans represent a disproportionate percentage of patients with hypertension. The combination of high-risk factors, genetic predisposition and poor access to quality health care exacerbates the problem. There is an urgent need to educate African-Americans about the dangers of high blood pressure and motivate them to do the work with their doctors and nurses to maintain normal blood pressure levels."

Former linebacker Jones knows all too well the dangers associated with heart disease and high-blood pressure. Although he prides himself on staying in good physical condition, he was still diagnosed with high blood pressure. "When I learned that my blood pressure was higher than normal, I talked to my doctor about treatment solutions," Jones says. "Now I diet, exercise, take my medication and check my blood pressure every day."

Doctors are increasingly stressing the importance of a diet low in fat, cholesterol and sodium. In fact, it has been said that a healthy diet high in fruits and vegetables is one of the first defenses against cardiovascular disease. And lowering salt and sodium intake is an effective way to help lower blood pressure. Most Americans consume more salt than they need. The current recommendation is to consume less than 2.4 grams of sodium a day. That equals 6 grams (about 1 teaspoon) of table salt a day. The 6 grams include ALL salt and sodium consumed, including that used in cooking and at the table. For someone with high blood pressure, the doctor may advise eating less salt and sodium, as recent research has shown that people consuming diets of 1,500 mg of sodium had even better blood pressure-lowering benefits. Lower-sodium diets also can keep blood pressure from rising and help blood pressure medicines work better.