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

High cholesterol, diabetes, high blood pressure, stress, lack of exercise, family history of heart disease, and obesity are all connected and are high-risk factors contributing to heart disease. More than 70% of black women are overweight and 49.7% are obese as opposed to 57.3% of white women who are overweight and 30.1% who are obese. In addition, 75% of African Americans do not have a healthy blood pressure (120/80 or below is considered healthy). These risk factors can be controlled through regular exercise and healthy diet, but for African Americans, our love of soul food and convenience foods has been difficult to balance. Combine that with the sedentary lifestyle of the overworked professional and you have several risk factors compounded. "Most of us are one generation away from a diet where [soul food] was viewed as the most desirable diet," says Dr. Charles Francis, president-elect of the American College of Physicians and former chief of medicine at Harlem Hospital. "Those unhealthy lifestyles seem to have a much greater detrimental effect on African Americans than on whites." Dr Francis suggests modifying traditional soul food dishes to include healthier ingredients and decreasing the amount of saturated fats, carbohydrates, and calories.

Jenkins tries to maintain a healthy, low-sodium diet and gets more sleep than she used to. Although her diabetes heightened her risk for a heart attack, her hectic lifestyle also created a lot of stress, which can impact the body negatively as well. "If you're not able to get rid of your stress, it stimulates negative metabolic activities in the body that leads to inflammation," offers Dr. Arthur Beau White of BlackHealthCare.com and formerly the National Institutes of Health. "Stress in conjunction with improper dieting and improper exercise leads to coronary heart disease. It's very simple."

People who have suffered a heart attack, especially diabetics, will most likely have future heart attacks. "The average bypass lasts only about 10 years, so it's definitely possible that I'm going do this again before 40," says Jenkins. "It's not advisable that I have kids--ever--and that's very hard to deal with." Studies show that women are almost twice as likely as men to die after bypass surgery.

"Women, particularly African American women, die at the highest rates from heart disease. Historically, women have been underdiagnosed and undertreated for heart disease. They have also participated in far fewer clinical trials than men.

But most people can avoid heart disease by simply eating right and exercising. In addition, knowing family history is key. "Even though you may be thin, if your mother died of a heart attack or had a stroke or has hypertension or diabetes, you should be tested, especially in families where heart disease is common," says Francis. Some doctors are using a test that screens for the C-reactive protein, a marker of inflammation, especially on those who have a strong family history of heart disease.