Health Essentials from Cleveland Clinic

Heart disease remains the leading cause of death in the United States. That statistic is of particular concern to African-Americans.

“In general, the prevalence of heart disease has decreased over time because of better medical management of risk factors. However, the risk of heart disease is still disproportionately higher among African-Americans,” says vascular surgeon Lee Kirksey, MD. 

A look at the numbers

Heart disease narrows or blocks blood vessels, making complications like heart attack and stroke more likely.

In America, 44 percent of black men and nearly 48 percent of black women have some form of heart disease, including heart disease and stroke.

Chronic conditions such as hypertension (high blood pressure), diabetes and obesity  increase the risk for heart disease and affect African-Americans disproportionately:

• Hypertension affects 45 percent of African-American men and 45 percent of African-American women compared with 35 percent of white men and 32 percent of white women.
• Diabetes is found in 13 percent of African-Americans compared with 8 percent of white Americans.
• Obesity affects 48 percent for African-Americans compared with 35 percent of white Americans.

Theories about the increased risk

Why such issues have affected the African-American community in such a lopsided way is not clearly understood, according to Dr. Kirksey. “The reason behind the increased prevalence of heart disease in African-Americans is multifactorial. Identifying the leading factor is somewhat controversial,” he says.

Doctors suspect that genetic, environmental and social factors are at play.

“Heart disease has a genetic component, which is probably activated by certain social or environmental risk factors, including stress, diet and exercise,” Dr. Kirksey explains.

“There is even a theory that an increased sensitivity to salt intake, originating centuries ago in African Americans, results in a high prevalence of hypertension, but that has not been fully proven.”

Social factors that can make healthy lifestyles a challenge for African-Americans, especially in urban areas, include the following:

• Regular doctor visits may not be the norm if stigma, mistrust and anxiety persist about medical institutions and the healthcare system.
• Information about how to keep your heart healthy may not be widely available.
• Grocery stores near home or work may not carry a good selection of nutritious foods.
• Some neighborhoods may not offer access to parks or exercise facilities.

No matter what the challenges, seeing a doctor to assess your heart disease risk factors is critical.

“As an African-American physician, I’d like to emphasize that identifying an existing heart condition early allows your physician to tailor a medical regimen and recommend lifestyle modifications to treat the specific cause,” says Dr. Kirksey. Delaying diagnosis and treatment until the later stages of heart disease will lead to worse outcomes, he notes. 

5 ways to reduce your risk

Meanwhile, Dr. Kirksey recommends making five lifestyle changes that will reduce your risk factors for heart disease:

1. Quit smoking. Smoking significantly increases your risk of heart disease. It’s not easy to quit, but doctors have several methods that can help you kick the habit, he says.
2. Exercise on most days. Aim to get 20 to 30 minutes of exercise at least five times per week. If you live in an area that doesn’t have a park or gym, look for ways to get in daily exercise at work or at home, Dr. Kirksey says. You don’t need exercise equipment. Try going up and down a flight of stairs. Even walking in circles while lifting your knees as high as possible can work your muscles and your heart.
3. Watch your diet. Dr. Kirksey recommends following a heart-healthy diet that is low in salt, sugar (especially processed sugars), animal fats and saturated fats. The more fresh fruits and vegetables you eat, the better.
4. Know your numbers. Work with your doctor to keep your blood pressure and cholesterol at normal levels. Diet and exercise can help with that.
5. Limit stress. You can’t always avoid stress in your life, but look for ways to manage your stress.

Awareness is growing

“Awareness of heart disease and the impact of healthy behaviors on heart disease is increasing in the African-American community,” says Dr. Kirksey. “We have to continue to raise public awareness, especially with childhood programs. This can definitely be impactful across generations.”

If parents teach children about the importance of healthy eating and regular exercise early on, they can become habits as children grow up, he says.