AHA releases scientific statement on cardiovascular health in African-American patients
Obesity, hypertension, and diabetes generally occur earlier in African-American patients than in white patients, and adverse health behaviors may partly explain the higher burden of risk factors for cardiovascular disease.
Traditional cardiovascular risk factors are more prevalent among African-American patients and disease onset is generally earlier, according to a new scientific statement from the American Heart Association (AHA).
The AHA's statement was based on the literature and on CDC data and aimed to describe cardiovascular health in African-Americans and to highlight considerations for prevention and management of disease. The statement noted that according to federal data, life expectancy was 3.4 years shorter in African-Americans than in whites in 2012. White women had the longest life expectancy, while black men had the shortest (81.4 years vs. 72.3 years, respectively). In CDC data from 2009, an estimated 32% of the mortality difference between African-American men and white men and 43% of the mortality difference between African-American women and white women is thought to be due to cardiovascular disease (CVD), the statement said.
The statement, which was published online Oct. 23 by Circulation, found that obesity, hypertension, and diabetes generally occur earlier in African-American patients than in white patients and that adverse health behaviors may partly explain the higher burden of risk factors for CVD. The statement concluded that effective implementation of evidence-based guidelines and population-based strategies could help improve cardiovascular health and lower risk in African-American patients.
Regarding comorbid conditions, the statement noted that African-American patients appear to progress faster to end-stage renal disease but have better survival on dialysis than white patients. Regarding risk prediction, the statement pointed to “ample evidence” that traditional CVD risk factors are as good at predicting outcomes in African-American patients as in white patients and noted that more recent risk prediction equations that include risk for stroke could be particularly useful in the former group. “The utility of these equations for counseling about disease risks, and ultimately for prevention, can be enhanced when they are coupled with the selection of pharmacotherapies specifically recommended for disease prevention among African Americans,” the statement said.
The statement noted that progress is needed in addressing the burden of CVD morbidity and mortality among African-American patients and that collaboration across many disciplines, as well as additional research, will be necessary. In addition, the statement said, diversification of the health care workforce and increased cultural competency could help to increase engagement of African-American patients in the health care system and improve interactions between patients and clinicians.
“With the considerable amount of information that we have about the prevalence and sources of disparities in cardiovascular health between African Americans and other racial/ethnic groups, we stand poised to address and eliminate those disparities with contributions from professionals with expertise in basic science and pharmacology, clinical medicine, and public health,” the statement authors wrote. “By successfully translating findings from across disciplines, scientists and practitioners from other disciplines can apply innovative strategies to improve the cardiovascular health of African Americans.”