Study Finds Younger Blacks Have More Heart Failure
However, those findings are based on a very small number of heart failure cases, the authors said, so more study is needed.
The takeaway message is that doctors should be more aggressive about treating young blacks who may be at risk, some experts said.
“Usually this is a disease of the elderly,” said Dr. Kirsten Bibbins-Domingo, one of the studys authors. “When this disease happens in 30 and 40 year olds, its quite dramatic.”
The research appears in Thursdays New England Journal of Medicine.
Heart failure occurs when the heart loses its ability to pump sufficient blood through the body. Its often fatal, but not always – some suffer disabling shortness of breath, fatigue and retention of fluids in their legs or lungs.
Earlier studies of heart failure, focused mainly on older people, showed heart failure rates were two to three times higher in blacks than whites.
In the new study, the researchers looked at data from more than 5,100 blacks and whites in Chicago; Minneapolis; Birmingham, Ala.; and Oakland, Calif. The participants were ages 18 to 30 at the time they joined the study more than 20 years ago.
Over the years, 27 people developed heart failure by age 50 and all but one were black. Five people died, all of those black.
At the outset, blood pressure levels and weights were similar, no matter which race, said Bibbins-Domingo, an epidemiologist at the University of California at San Francisco.
But the researchers found that a disproportionate number of blacks developed high blood pressure in their young adulthood and went on to suffer heart failure. Blacks also were more likely to develop diabetes and chronic kidney disease, and to suffer an impairment in the heart muscles ability to contract.
Its not clear why more blacks develop those problems so early, Bibbins-Domingo said. Possible explanations range from income and social environment to genetics, she added.
Another mystery: Researchers told those who were diagnosed with high blood pressure to see their doctors about it. But 10 years into the study, the condition was untreated or poorly controlled in 3 out of 4 black patients diagnosed.
Treatments need to be effective and affordable, and doctors also must follow up with patients to make sure theyre taking their medicines and, if they arent, find out why and address the obstacles, he added.
“We as physicians are so quick to say its the patients fault. But I would argue the system has failed,” Peterson said.
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On the Net:
New England Journal: http://nejm.org