| For decades, heart disease has cut a wide swath | | | | surgery or even an aspirin." Historically considered a |
| through the health and well-being of American society. | | | | man's disease, women present much milder, vague |
| Over 70 million Americans are living with a form of | | | | symptoms than male counterparts, which are often |
| heart disease, and it is the most likely cause of death. | | | | missed by both primary physicians and cardiologists. |
| Statistics for African Americans are particularly dire. | | | | Because they do not the display the heart clutching, |
| Of 5 million individuals diagnosed with heart disease, | | | | Hollywood version of an attack most associated with |
| 725,000 are African American, with an estimated | | | | heart failure, they are often misdiagnosed or |
| increase of 900,000 expected by the end of the | | | | under-treated despite the existence of one or more |
| decade. Although risk factors are identical across racial | | | | risk factors. After weeks of persistent breathlessness |
| groups, blacks present multiple factors and symptoms | | | | and vague sense of physical unease, Joan Connell, |
| are likely to be more advanced and aggressive. In | | | | then 42, an accounting professional at Ziff Davis |
| 2003, American Heart Association statistics showed | | | | Publishing, went to the emergency room convinced |
| an alarming 41% of black males and 44.7% black | | | | she was having a heart attack. Despite being an |
| females had cardiovascular disease compared to | | | | overweight smoker who had been physically inactive |
| 34.3% and 32% of white respectively. The harsh social | | | | for years, she was sent home. A week later she |
| and economic realities of African American life have | | | | returned with a second heart attack and was rushed |
| exacerbated the onslaught of the disease, towards | | | | into emergency bypass surgery which revealed four |
| which we are seemingly predisposed. Despite this, | | | | blocked arteries. |
| blacks remain the most underrepresented and under | | | | This year, the National Institutes of Health released the |
| served population in research studies, clinical trials and | | | | Women's Ischemic Syndrome Evaluation study (WISE) |
| treatment. Black women, who have the highest risk | | | | to address the discrepancy in symptoms between |
| factors, remain the lowest on the healthcare ladder for | | | | men and women and to assist physicians in identifying |
| diagnosis and life-saving tests and treatment and are | | | | and treating the illness in women. Symptoms in men |
| 69% more likely to die from a heart attack or stroke | | | | include angina (chest pain), pressure or discomfort in |
| than white women. Grim health outcomes | | | | the chest or a tingling sensation in the arm of on one |
| notwithstanding, it is possible to reverse medical | | | | side of the body. Women, however, experience a |
| predictions to achieve and maintain optimum health | | | | broader constellation of symptoms over a prolonged |
| through education and positive lifestyle changes. | | | | period of time. Dr. Patrice Desvigne-Nickens, MD, Head |
| Risk Factors | | | | of the Cardiovascular Medicine Scientific Research |
| The risk factors for heart disease are as follows: | | | | Group at the National Heart Lung and Blood Institute in |
| hypertension; family history; cigarette smoking; diabetes; | | | | Bethesda, Maryland explains, "In the presence of one |
| obesity; high blood cholesterol and physical inactivity. | | | | or more pertinent risk factors, women present a wider |
| Previously, increasing age and gender were | | | | set of symptoms for cardiac ischemia which results in |
| determining factors; though this is no longer true as the | | | | heart attack. These symptoms include fatigue; |
| disease has been diagnosed at increasing younger | | | | shortness of breath; feelings of indigestion and ill health; |
| ages. Each year, 40,000 more women than men | | | | palpitations; neck, shoulder and upper back pain; |
| suffer strokes and women account for 51% of the | | | | nausea; vomiting; sweating and lightheadedness." |
| total heart disease. Secondary risk factors are high | | | | Connell says that Black women's superwoman |
| levels of triglyceride, the most common type of fat in | | | | syndrome is detrimental to women's health and |
| the body which accelerates to high cholesterol and | | | | receiving proper care. "We are often over-stressed |
| diabetes; excessive alcohol in-take and previous heart | | | | from working two jobs, taking care of family and |
| attack or stroke. | | | | juggling multiple responsibilities, the last thing we have |
| Risk factors and symptoms tend to be higher and | | | | time for is taking care of ourselves." According to Dr. |
| more destructive in blacks. For example, a black, | | | | Desvigne-Nickens treatment is time-sensitive therefore |
| female diabetic, with attendant factors of obesity and | | | | the level of damage and the expeditious delivery of |
| a sedentary lifestyle, may be so far advanced that a | | | | treatment plays a significant part in determining the |
| limb may need to be amputated. Dr. Malcolm Taylor, | | | | severity of the damage and if the patient survives the |
| MD, Assistant Clinical Professor for University Medical | | | | attack. Self-care is not selfish. Dr. Desvigne-Nickens |
| Center, in Mississippi, Director of the Congestive Heart | | | | says, "Doctors must pay close attention in order to |
| Failure Clinic at St. Dominic-Jackson Memorial Hospital | | | | discern symptoms and then order the appropriate test. |
| and former President of the Association of the Black | | | | Women must feel empowered to act quickly to get |
| Cardiologists explains, "Diabetes is not only a disease | | | | the necessary treatment." |
| involving glucose, it also causes premature aging of the | | | | Treatment: Cutting Edge Technology, Medication, |
| blood vessels. That's why the number one cause of | | | | Protection and Testing |
| death for diabetics is cardiovascular diseases." The | | | | Take heart. Over the years scientists and |
| virulence of the risk factors have led researchers and | | | | pharmaceutical companies have developed |
| genetic scientists to explore the existence of intrinsic | | | | sophisticated treatment methods, dose-appropriate |
| biological determinants or a human genome that make | | | | medications and minimally invasive techniques which |
| blacks more naturally predisposed susceptible to | | | | have proved effective in the treatment of heart |
| certain chronic illness such, genes for salt retention that | | | | disease. Often EKGs fail to accurately show measure |
| causes hypertension and another for that exacerbates | | | | heart defects. Imaging studies have revolutionized how |
| diabetes. | | | | doctors view - and treat - vessel and organ damage. |
| The prevalence of hypertension in African Americans | | | | · Angiography or arteriogram - a procedure that uses |
| is the highest in the world and plays a significant role in | | | | X-ray and a special dye to see inside the arteries, |
| cardiovascular complications. Clinical Director of the | | | | veins and heart chambers to detect narrowing or |
| Hypertension and Vascular Biology and Head of the | | | | blockage of the vessels. Other forms of angiographies |
| Hypertension Division of Cardiology at the University of | | | | which correspond with various parts of the body |
| Maryland School of Medicine in Baltimore, Maryland | | | | include renal, aortic and coronary. |
| and a founding member of the Association of Black | | | | · Carotid Ultrasound - illustrates blood flow and the |
| Cardiologist, Dr. Elijah Saunders asserts that one | | | | narrowing of the blood vessels. |
| African-American dies as a result of high blood | | | | · Cardiac Scanning (CT) - examines how well the |
| pressure every hour in the US, which is nearly twice | | | | arteries diffuse blood |
| as often as whites. "Blacks also develop high blood | | | | · Ankle Brachial Index - predicts the presence and |
| pressure at younger ages than whites and suffer | | | | the severity of peripheral artery disease. The patient's |
| more damage to their organs as a result of the | | | | blood pressure is first taken at rest in the arm and in |
| disease." The pressure of stressful life experiences | | | | the foot and again several minutes later. A reading |
| negatively impacts cardio vascular health. In today's | | | | under one indicates narrowing of the blood vessel. DR. |
| fast-paced, competitive environment, a number of | | | | Mendes also suggests checking the pulse in the groin, |
| external components contribute to elevated blood | | | | behind the knees and in the leg. |
| pressure including social-economic factors such as | | | | · Stress tests - used to determine the amount of |
| career pressure, lack of or underemployment, | | | | stress the heart can manage before developing either |
| substandard living conditions and racism. In addition, lack | | | | an abnormal rhythm or evidence of ischemia. One of |
| of adequate healthcare and shoddy management of | | | | the more popular, the treadmill test provides information |
| chronic illnesses paves the way for long-term heart | | | | on how the heart responds to exertion and involves |
| failure. Stress stimulators often trigger the development | | | | walking on a treadmill or pedaling a stationary bike at |
| of calcification which causes injury to the cells. The | | | | varying levels of difficulty, while electrocardiogram, |
| accumulated calcium becomes a marker for | | | | heart rate and blood pressure are monitored. |
| aththerosclerosis, a thickening and hardening of artery | | | | Because of the under-representation of blacks in the |
| walls which eventually blocks the arteries. | | | | heart disease studies, the FDA has mandated greater |
| The culture of eating, not to nourish but to fuel the | | | | minority inclusion in clinical trial. Now there are several |
| body, is a particular egregious contributor to | | | | medications that mitigate the multiple risk factors. |
| cardiovascular disease, which relates to the arteries | | | | Rimonabant, available in 2007 blocks receptors in the |
| and vessels within the cardiac system. While many | | | | brain that help reduce the risk of heart disease and |
| Americans are aware that poor nutrition and lifestyle | | | | Type 2 diabetes. Others currently available are |
| are not conducive to optimal health, cultural practices | | | | designed to raise HDLs (good cholesterol) and lower |
| are difficult to break. Fried and starchy foods, heavy | | | | plaque. Dr. Taylor explains, "Patients' response is |
| salt intake, dairy, unsaturated fats and high cholesterol | | | | dose-dependent. African Americans tend to need |
| meals - staples of traditional African American cuisine - | | | | higher doses to get better results and greater cardiac |
| are major causes of aththerosclerosis. Over time, the | | | | benefit. |
| accumulation of hard-to-process foods particles | | | | · BiDil has been specifically shown to reduce mortality, |
| creates a blockage in the vessels which eventually | | | | hospitalization and improve quality of life. |
| compromises the arterial walls. Americans' increasing | | | | · Beta Blockers lowers blood pressure, treats chest |
| corpulence and ever-expanding waist line also weighs | | | | pain and assist in the recovery of heart attack |
| heavily. Lisa Jubilee, nutritionist and co-founder of Living | | | | survivors. |
| Proof, Nutrition and Fitness Center in New York City | | | | · Ace Inhibitors and angiotensin dilates the blood |
| says, "We're observing the phenomenon of the skinny, | | | | vessels to improve the amount of blood the heart |
| fat person who looks great dressed up and doesn't | | | | pumps and lower blood pressure. ACE inhibitors also |
| weigh much, but have substantial fat deposits stored in | | | | increase blood flow, which helps to decrease the |
| their midsection causing an apple shape." The | | | | amount of work the heart does. |
| abdominal fat causes heart disease by pressing into | | | | In addition to angioplasty (inserting a balloon) and stents, |
| the internal organs and decreasing the oxygen supply | | | | minimally invasive surgeries have transformed heart |
| to various parts of the body. | | | | disease treatment, resulting in shorter hospitalization |
| Yo-yo dieting is also vicious enemy to the heart and | | | | and recovery time, improves medical outcomes, |
| the body's metabolic system. The shock of food | | | | causes less complications and trauma and is more |
| deprivation and supply places substantial stress on the | | | | economical. |
| body and hinders its ability to lose weight naturally. | | | | · Off-Pump Bypass (beating heart surgery) is |
| Jubilee explains, "Your body doesn't care if you're | | | | performed on a beating heart and reduces the risk of |
| trying to lose weight or build muscle, its main focus is | | | | medical complications including stroke, bleeding and |
| survival. Therefore it will try to find nutrients however it | | | | renal failure. |
| can, even it means metabolizing muscle which will then | | | | · Anjiojet - Saline jets create a powerful vacuum |
| cause atrophy." Gradually, vacillating dieting habits | | | | within the artery, breaking up the clots, and removes |
| weakens the heart muscles and leaves other organs | | | | pieces through a catheter and into a pump. |
| susceptible to cardiovascular disease. | | | | · Trans-Myocardial Laser Revascularization (TMLR) |
| What to Look For: Symptoms and Signs | | | | employs a laser to create blood perfusion channels in |
| The body sends a number of signals to the individual | | | | the heart that supplements the function of the |
| to bring about life-saving change. One of the most | | | | coronary arteries. |
| flagrant signals is a transit ischemic attack (TIA) or | | | | Prevention |
| "mini stroke." Dr. Donna Mendes, Chief of Vascular | | | | A diagnosis of heart disease is not a life sentence nor |
| Surgery at St. Luke's Roosevelt, Uptown in New York | | | | should it be a source of shame or weakness. It |
| City, Clinical Professor of Surgery at the College of | | | | presents everyone with the opportunity to recreate |
| Physicians & Surgeons, and the first African American | | | | and rejuvenate their life through awareness, proper |
| female to become board certified in the specialty of | | | | diet and exercise and healthy lifestyle changes. |
| peripheral vascular surgery explains, "A TIA occurs | | | | Reducing controllable risk factors is key. |
| when the blood vessel in the brain develops an ulcer | | | | · The core prevention messages are unchanged. |
| caused by high cholesterol. Plaque forms around the | | | | This includes becoming physically active, smoking |
| crater which eventually breaks off and makes its way | | | | cessation and maintaining weight level in keeping with |
| through the blood stream towards the brain. The | | | | one's height and specific body type. |
| portion of the brain impacted will suddenly experience | | | | · Diet. Reduce intake of saturated fats found in dairy, |
| decreased blood flow, resulting in a TIA." The part of | | | | red meats, and organ meats such as liver, kidney, |
| the body controlled by that portion of the brain | | | | sausage and giblets. Incorporate vegetables and foods |
| becomes impaired, lasting from a few minutes to | | | | in their natural forms such as whole grain and high fiber |
| twenty-four hours. For example, while combing the hair | | | | foods which help unclog arteries. Avoid white foods |
| the comb may fall from a person's hand. Other | | | | which have been drained of their nutritional content. |
| indicators include loss of sensation on one side of the | | | | This includes bread, sugar and pasta. Avoid products |
| body, loss of vision, motor function or intermittent pain | | | | containing high fructose corn syrup contained in sodas |
| in the calf after walking, which results from decreased | | | | and fruit juices. |
| oxygen and blood flow. Peripheral artery disease is | | | | · Know your numbers - blood pressure, cholesterol, |
| also a major element in the development of heart | | | | blood sugar - so that you can control your risks. |
| disease. It affects arteries which emanate from the | | | | · Learn how to read food labels. Some processed |
| heart, which, when damaged, causes stroke, gangrene | | | | foods and nutritional bars that contain mysterious fillers. |
| or amputation of the lower extremities. | | | | Analyze the content before consuming the product. |
| Despite exhaustive studies of heart disease in | | | | Ultimately, education is key and African Americans |
| Caucasians, scientists have only recently begun to | | | | must assume greater responsibility for their own health. |
| study the presentation of the disease in African | | | | Dr. Taylor cautions, "A doctor will spend more time |
| Americans. Dr. Taylor asserts, "Blacks still receive less | | | | with a patient who knows something about their |
| cardiovascular care, even for acute symptoms, are | | | | disease. |
| less likely to receive EKGs, cardiac testing, bypass | | | | |