Public health experts have known for some time that heart disease and hypertension exact a heavy toll on African Americans, although they haven't always agreed on what to do about it.
African American adults are 30 percent more likely to die from heart disease than non-Hispanic whites, according to federal statistics. They are 40 percent more likely to suffer from high blood pressure than whites, less likely to have their blood pressure under control and three times as likely as whites to die from hypertension-related illnesses.
The good news, doctors say, is these health disparities can be reduced or even eliminated through a combination of lifestyle changes, medical treatment and smarter public policy.
Keith C. Ferdinand, M.D., a cardiologist who practiced in New Orleans' Lower Ninth Ward before Hurricane Katrina, says subtle genetic differences among different populations don't explain the differences in life expectancy, coronary heart disease, kidney disease, stroke and congestive heart failure.
"I think environmental or lifestyle factors are predominant," says Ferdinand, now of Atlanta, where he is a professor at Emory University and chief science officer of the Association of Black Cardiologists.
Where you live, whether there are parks nearby or whether you have access to fresh fruits and vegetables — what scientists call the "social determinants of health" — play a big role, he says.
A heart drug for African Americans
But medications can help.
Ferdinand was one of the investigators in the trial of a heart drug called BiDil, which was tested on nearly 1,150 African Americans. The study, published in 2004 in the New England Journal of Medicine, reported a 39 percent reduction in hospitalization and a 43 percent reduction in deaths compared with placebos, as well as an overall improvement in the quality of life.
The drug — a unique formulation of two older medicines — was approved by the Food and Drug Administration in 2005 with a label specifying it for use in African American patients, the first time it had done so.
"The medicine is good and it does work," Ferdinand says. "There was some push-back in terms of labeling a drug for blacks only. I actually agree with that criticism." He says the medicine shouldn't be limited to one group.
The drug's original manufacturer later sold its rights to another pharmaceutical company, making the medicine harder to obtain, but Ferdinand says it is available.
How to prevent cardiovascular disease
Doctors can treat hypertension and many heart problems with drugs, Ferdinand says, "but the overall burden of cardiovascular disease can only be curtailed by prevention. We're not going to be able to medicate, cut or scrape our way out of the epidemic of heart disease we see in the United States."
Effective prevention includes good prenatal care, proper childhood nutrition and aggressive efforts to control obesity and hypertension, Ferdinand says.
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