A panel discussion hosted by BlackDoctor.org brought together a group of healthcare professionals and a patient advocate to discuss the critical issue of heart health for Black women. The conversation, part of a series on cardiac care, offered valuable insights for healthcare providers working to address cardiovascular disparities and improve outcomes in this population.
Unique Heart Health Challenges and Risk Factors for Black Women
Michelle Wallace, MD, a pediatric cardiologist, emphasized the disproportionate impact of cardiovascular disease on Black women: “We are uniquely impacted because we are disproportionately impacted and more severely impacted.” Keith Ferdinand, MD, a cardiologist at Tulane University School of Medicine, added a stark comparison: “Compared to white women, they have more heart disease and strokes such that the life expectancy of a Black woman is shortened.”
Key risk factors highlighted include:
- Hypertension: Dr. Ferdinand stressed, “It’s three to four times more common in the Black population and more common in Black women versus white women.”
- Diabetes: “More Black women have diabetes than white women,” noted Dr. Ferdinand.
- Obesity and physical inactivity
- Smoking
- Genetic factors: Dr. Ferdinand mentioned, “There’s also a condition called amyloid cardiomyopathy. It’s more common in people of West African descent.”
The panel stressed the importance of early screening and intervention, with Dr. Wallace noting that many risk factors begin developing in adolescence.
Social Determinants of Health
The discussion touched on how stress and social determinants of health contribute to higher rates of heart disease. Dr. Wallace explained, “There’s also been some evidence that exposures to different things in the environment may also play a role in your cardiovascular disease risk.”
Dr. Ferdinand introduced the concept of “social determinants of health,” explaining how disadvantaged living situations can lead to chronic stress, affecting cardiovascular health. He noted, “We know that people who live in a disadvantaged situation… may be always under stress. They can’t sleep. The blood pressure doesn’t go down at night because they can’t get a good rest.”
Prevention and Lifestyle Modifications
The experts provided several recommendations for prevention and lifestyle modifications. Irini McCarthy from the American Heart Association emphasized, “Eating a healthy diet, you know, full of vegetables, fruits, whole grains, legumes, nuts, plant-based proteins.”
Dr. Wallace stressed the importance of starting healthy habits early: “I think that it is very important that we remember that these things are a lot of some of these things are cultural, they are lifestyle-related, and it’s important that we teach our children that what’s what they can modify and teach them how to lead a healthy lifestyle.”
Heart Disease Diagnosis and Treatment
The panel discussed key warning signs and symptoms of heart disease. Dr. Ferdinand noted, “Usually, it’s uncontrolled hypertension, diabetes, heart attack that caused the common things caused the common things.” Regarding treatment, Dr. Ferdinand stressed the importance of medication when necessary: “I would like really for the American population, especially for the Black population to move away from this idea that medicines are bad. If you have high blood pressure, if your cholesterol is markedly elevated… It’s hard really just to lifestyle it away.”
For diagnosis, the experts recommended:
- Thorough patient history, including family history
- Lipid panels, including lipoprotein(a) testing
- Genetic screening in cases of strong family history or early-onset disease
Regarding treatment, Dr. Ferdinand stressed the importance of medication when necessary, urging healthcare providers to address any patient concerns about taking medicines. He advocated for shared decision-making and being open to trying different medications if side effects occur.
Patient Advocacy and Cultural Competence
Angela Brooks, a patient advocate diagnosed with congestive heart failure, shared her experience: “I’m lucky that I, one, listened to my body, but that my doctor took me seriously, and really did a great job of advocating for me with my insurance company.”
The discussion also touched on the need for culturally competent care, including understanding traditional dietary practices and providing appropriate alternatives. Dr. Ferdinand mentioned the Association of Black Cardiologists as a resource for culturally tailored heart-healthy recipes and information.
Key Takeaways for Healthcare Professionals
- Screen early and often: Dr. Wallace emphasized, “For all patients between the ages of nine and 11, we’re recommending that they have a lipid profile.”
- Address social determinants of health: Incorporate questions about stress, living situations, and access to healthy foods into patient assessments.
- Provide culturally competent care: Understand cultural dietary practices and offer appropriate, realistic lifestyle modifications.
- Encourage patient advocacy: Brooks advised, “Learn to advocate for yourself.”
- Consider genetic factors: Dr. Ferdinand suggested, “The next time you’re getting what they call a lipid panel where they’re checking the cholesterol, ask your doctor to check the [Lipoprotein(a)].”
- Emphasize medication adherence: Dr. Ferdinand stressed, “Don’t just throw the medicine away. Don’t just say what’s not working or I’m getting this side effect or that side effect. Do shared decision making.”
- Promote family-based interventions: Dr. Wallace noted, “We are frequently the leaders of lifestyle in our families… model a healthy lifestyle for your children.”
By understanding the unique challenges facing Black women in terms of heart health and implementing these strategies, healthcare professionals can play a crucial role in reducing cardiovascular disparities and improving outcomes in this population.