With every beat: heart disease is the leading cause of death in the United States. Do you know if you're at risk?

Black Enterprise, May, 2004 by Keisha-Gaye Anderson

During the final week of exams, as Belinda Jenkins got dressed to go out with her sister, she was struck with an intense pain in her chest, which she dismissed as indigestion, But before she could pop a TUMS, she collapsed, crippled by the pain. As she lay on the ground gasping for air, she frantically managed to call 911, before losing consciousness shortly afterward. At 26, Jenkins was having a massive heart attack that nearly took her life.

Heart disease is a slow killer that usually catches victims off guard because they either don't: know their risk factors or they don't recognize the warning signs, until it's too late. There is even more shocking news: in a recent survey of 1,000 at-risk baby boomers, conducted by the Association of Black Cardiologists, 79% did not view cardiovascular disease as a major health concern. Only 23% believed they were personally at risk. Each year, approximately 1 million Americans have a heart attack, which accounts for 41% of all deaths in the United States. Heart disease is the leading cause of death for African Americans, especially women. According to the American Heroic Association, 40% of African American women died from heart disease in 2000.

"It was literally a wake-up call for me to slow down," says Jenkins, now a 27-year-old marketing coordinator for National Repro Graphics in New York. "I was doing way too much between work, school, and home." Jenkins also suffered from Type I diabetes since the age of 2 and was very disciplined in minding her health. She took insulin shots, watched her diet, and kept fit through sports, even playing for the college volleyball team during her freshman year. But while attending college full time, she also worked full time to finance her education, and her hectic schedule took a toll on her health. At times, she ran on four hours of sleep and downed pizza for lunch--when she had time. "There was a lot of stress to be able to keep myself in college and also pay my bills," she says.

It wasn't long before she started experiencing classic symptoms of a heart attack. "Two weeks before everything occurred, I had been experiencing some tightness in my chest, some shortness of breath," recalls Jenkins. "I'd wake up in the middle of the night with [my heart] racing in my chest, and I would just attribute it to maybe a nightmare or something." These symptoms, her history of diabetes, and the fact that her entire family suffered from diabetes, made Jenkins a likely candidate for a heart attack, despite her young age.

"Diabetes is a much more powerful risk factor for heart disease in women than in men," explains Dr. Jennifer Mieres, director of nuclear cardiology at North Shore University Hospital in Manhasset, New York. "There's a three- to seven-fold increase of heart attacks in diabetic women compared to a two-fold increase in diabetic men across the board." Two out of three people with diabetes die of some type of cardiovascular disease.

Diabetics don't produce insulin, and without insulin, high levels of glucose build up in the blood. Glucose damages the walls of blood vessels and makes them ripe for the build-up of plaque, which constricts the flow of oxygen-filled blood to the heart. The heart, like any other muscle in the body, needs a healthy supply of blood to function. It struggles to perform when that flow is diminished.

Jenkins' heart attack was caused by five blocked arteries, which required her to have quintuple bypass surgery. "Quintuple bypasses don't happen a lot. You usually hear about a double, a triple," says Jenkins. Her condition was so rare that doctors in the ER first thought it was a result of substance abuse.

"I showed up to the emergency room in a sweater, a pair of pants, and I had no socks on. I had no shoes on. I had no identification. I didn't have a pocketbook," says Jenkins. "They initially ran a toxicology test on me. They thought I was on drugs." They ran an EKG test twice as Jenkins lay there for 45 minutes crying in pain and vomiting.

During her six hour-plus surgery, her heart and lungs were removed from her body and hooked up to a heart and lung machine, while arteries taken from her leg were used to replace the blocked ones in her heart. The incision made on her inner thigh, running from groin to calf, is painfully and slowly healing. "When I first came home, I couldn't even fold my leg at a right angle. Sitting at the table was not an option." Her healing process will be long and slow, and facilitated by several medications--Zocor for cholesterol, Toprol for blood pressure, aspirin, folio acid for circulation, insulin, water pills to reduce swelling in her leg, and thyroid medication.

Jenkins' diabetes is impeding the healing process for her leg. "Diabetes takes a toll on your body," she explains. Jenkins also suffers from thyroid disease, another illness that runs in her family. She was diagnosed 13 years ago after she stopped growing for a two-year period during her teens and inexplicably started gaining weight. Jenkins has recently tested positive for the Rheumatoid factor as well, which signals the possible onset of Rheumatoid arthritis, another autoimmune complication. She had also maintained high cholesterol levels since high school. "You don't see a lot of high school kids on cholesterol medication, but at the same time, for preventative maintenance, it would have made some sense," says Jenkins.