Studies Indicate That Black Athletes Have Different Cardiovascular Characteristics Than Whites, But Differences Are Not Necessarily Precursors for Disease

Black athletes are more likely than white athletes to have abnormal electrocardiogram patterns and thicker ventricle walls in their hearts, but the differences are not necessarily precursors for heart disease, according to two separate studies published in the June issue of the Journal of the American College of Cardiology, HealthDay/U.S. News & World Report reports.

The first study -- led by Anthony Magalski of the Mid-America Heart Institute and team physician for the National Football League's Kansas City Chiefs -- examined almost 2,000 athletes participating in the NFL Invitational Camp between 2000 and 2005. Study researcher Barry Maron, director of the Hypertrophic Cardiomyopathy Center of the Minneapolis Heart Institute Foundation, said, "There has been for many years the idea that there are racial differences in the expression of the ECG in normal people, as well as those with heart disease. None of it had ever been proven. This is the first to show differences in healthy young people."

Researchers found that 30% of black players had abnormal ECG patterns, compared with 13% of whites. ECGs record the electrical waves that cause the heart muscle to pump.

Maron noted that "abnormal" does not necessarily mean "unhealthy." He said that the "criteria we have always used for normality are based on data from white people, and it turns out that black and white people are not identical in this regard." Abraham Friedman, a clinical associate professor of medicine at the University of Pittsburgh, noted that such differences, upon further evaluation, "may not speak (to) disease."

Maron added that the findings indicate that routine screening of young athletes for heart disease based on ECGs "would be confusing if not chaotic" because "the ECG in blacks are more likely to be abnormal. That would raise the possibility of heart disease more frequently -- an unbalanced situation." He added, "Black athletes are more likely to be judged incorrectly to have heart disease." Friedman said screening should take into account the differences between blacks and whites.

A second study, led by Sanjay Sharma of London-based Kings College Hospital, London, found that in comparison to 300 white European athletes, 300 black European athletes had a greater thickness of the wall of the left ventricle in the heart. According to HealthDay/Reuters, the characteristic is typically considered a sign of heart disease. However, Friedman said, "Black athletes' hearts can be thicker than white athletes' hearts and still be normal" (Edelson, HealthDay/U.S. News & World Report, 6/2).

An abstract of the first study is available online. An abstract of the second study is also available online.

Screening, Awareness Effort
Winston Gandy, a cardiologist with the Association of Black Cardiologists, suggested that young black athletes need to be screened because they are at higher risk of sudden cardiac arrest. According to the American Heart Association, the reason why young black athletes are more likely to die from sudden cardiac arrest is likely because of "socioeconomic status and biases within the health care system" that limit many blacks' access to screening.

Winston is leading a national effort aimed at athletes, called Close the Gap, that seeks to address racial disparities in cardiovascular care. The campaign is sponsored by ABC, Boston Scientific's Cardiac Rhythm Management division, the Black Coaches and Administrators, the National Collegiate Athletic Association and other groups (White, Cox/Rocky Mount Telegram, 6/3).