As healthcare providers, we play a critical role in addressing the disproportionate impact of heart disease on Black men. Heart disease (also known as cardiovascular disease) is a group of conditions that affect the heart and blood vessels. Heart disease remains a leading cause of death across all populations, but Black men face higher risks.
Addressing heart health disparities is a crucial public health concern. In a live roundtable with BlackDoctor.org heart health experts, Keith Ferdinand, MD, emphasizes, “[Coronary] heart disease is the number one cause of death among all populations regardless of race or ethnicity. But in the Black community here in The United States, the rates of heart disease are even higher.”
Major Risk Factors
Several heart disease risk factors including hypertension, diabetes, family history, and social determinants of health contribute to the elevated high risk in Black men.
- Hypertension: Hypertension is more prevalent and severe in Black adults. Naddi Marah, MD, an interventional cardiologist at Memorial Hermann Medical Group, notes, “African American men experience high blood pressure and often at younger ages. But because it may not cause any immediate discomfort, it often goes either undiagnosed or untreated.” Untreated hypertension can lead to serious health conditions like heart attack, stroke and kidney disease and increase the risk of life threatening events.
- Diabetes: Carlos Ince, MD, a cardiologist at Mercy Medical Center, highlights, “Diabetes is probably the most prominent one that is growing, across all races, but disproportionately in African American populations.” Diabetes significantly increases the risk of heart disease.
- Family History: Dr. Ferdinand, Professor of Medicine at Tulane University School of Medicine, introduces an often-overlooked risk factor, high Lp(a) levels: “There is a blood test that’s not commonly done that probably should be done in everyone. It’s lipoprotein(a) [(Lp(a)]… It tends to be more common in people of West African and South Asian descent.”
- Social Determinants of Health: Dr. Ferdinand explains, “The social determinants of health…Those neighborhoods where you live, play, and pray have some of the highest risk for all the things we talked about hypertension, heart disease, dying early, increased death.” These factors, including food inadequacy and unsafe spaces to exercise, contribute to health equity disparities.
Symptoms and Diagnosis
Recognizing symptoms such as chest pain and being short of breath is vital for early detection. Early detection is crucial. Dr. Marah advises: “Blood pressure should be checked at least once a year at age 20… Cholesterol and blood sugar is a little bit different. We recommend getting that checked every four to six years or more often if you have a risk.”
William Cooper, MD, a cardiothoracic surgeon at North Kansas City Hospital, adds, “An [echocardiogram] is an ultrasound of the heart… It tells us if you have heart failure, whether it is heart failure where your heart is big and flabby or heart failure where your heart is thick and extremely muscular.” An echocardiogram is helpful to diagnose many types of heart disease, including those that affect the heart’s ability to pump oxygen-rich blood.
Treatment Approaches
When developing treatment plans, consider:
- Lifestyle Modifications: Maureen Meister, PhD, Research Scientist at Chemical Insights Research Institute, emphasizes, “I really have to advocate for whole plant foods. I mean, we don’t meet our fiber requirements. Half of the population isn’t meeting their fiber needs.”
- Medication: Dr. Ferdinand stresses to patients, “Don’t ask the guys in the barbershop which one to take because they’ll tell you it messes with your nature. Well, there are now medicines which are well tolerated and will not cause sexual dysfunction.”
- Stress Management: Dr. Cooper suggests, “My exercise is yoga, Pilates, tai chi. And so these things are out there. Some of them, you know, are not as difficult as you think.”
Overcoming Barriers to Care and Prevention
To improve heart health outcomes for Black men, we must address systemic barriers and prevent heart disease. Dr. Ince emphasizes the importance of patient engagement: “You’ve gotta engage. You’ve really got to take into account your own health and accountability and really doing all you can regardless of whether you’re in inner city Chicago or, you know, where I am right now, Downtown Kansas City.”
Key Takeaways
- Be Proactive: Dr. Marah advises, “Know your risk factors, pay attention to your symptoms, be proactive, be transparent with your physician, seek care as soon as you can, get screened because your health is your wealth and you may not have as much time as you think you do.”
- Address the Whole Person: Dr. Ferdinand reminds us, “Those social determinants of health have a big impact. Then you throw into the mixture structural inequities, having no insurance or having underinsured status.”
- Emphasize Prevention: Dr. Cooper emphasizes, “Remember, we’re here in this life to enjoy this life, and you can’t enjoy it in my Operating Room, or running around to this procedure and that procedure. So really get in front of these things.”
- Communicate Clearly: Dr. Ince stresses the importance of “establishing a good relationship with your physician. What your needs are today may not necessarily be what your needs are tomorrow.”
- Follow Up: Dr. Meister advises finding “a practitioner that you can trust, and that is going to listen to you and have an open dialogue with you, because without that, you know, you’re not gonna trust who’s giving you advice and the advice that’s given.”