Heart Failure Rate for Young Blacks 20 Times Higher Than Whites

One in 100 black men and women develops heart failure before age 50, a rate that is 20 times higher than whites in the same age group, according to a study published on Thursday in the New England Journal of Medicine, the AP/Boston Globe reports (Stobbe, AP/Boston Globe, 3/19). For the study, researchers from the National Heart, Lung and Blood Institute over two decades tracked 5,115 black and white men and women who were between ages 18 and 30 at start of the study (Brewington, Baltimore Sun, 3/19). The study was funded in part by the Robert Wood Johnson Foundation (Rabin, New York Times, 3/19). The completed study found that 27 participants had developed heart failure by age 50, 26 of whom were black. In addition, all five deaths in the study were black people (Baltimore Sun, 3/19).

According to Kirsten Bibbins-Domingo, an assistant professor at the University of California-San Francisco and lead author of the study, the research discovered that blacks in their 30s and 40s had the same rate of heart failure as whites in their 50s and 60s (New York Times, 3/19). Bibbins-Domingo also said that although blood pressure levels and weight were similar in blacks and whites at the start of the study, a disproportionate number of blacks developed high blood pressure in young adulthood and later suffered heart failure (AP/Boston Globe, 3/19).

Bibbins-Domingo said that the most notable risk factor was high levels of diastolic blood pressure, which if increased by 10 points among blacks in their 20s doubled the risk of developing heart failure between 10 and 20 years later (Baltimore Sun, 3/19). Although researchers told participants with high blood pressure to see a physician, the study found that the condition was "untreated or poorly controlled" in three out of four black patients, according to the AP/Globe (AP/Boston Globe, 3/19). Other risk factors included diabetes, kidney disease, obesity and low levels of HDL, also known as "good" cholesterol (New York Times, 3/19).

Comments, Suggestions
The AP/Globe reports that the study's small sample of heart failure cases warranted further research (AP/Boston Globe, 3/19). Some experts suggested that the findings are the "tip of the iceberg" because the study looked at patients only whose heart failure led to hospitalization or death (New York Times, 3/19). Researchers suggested that the medical community study the risk factors and conduct clinical trials to examine specific treatment for black patients.

In addition, they said that the findings should motivate health officials to establish prevention programs as early as high school and blacks to take better care of their health. Bibbins-Domingo said, "The consequences of having such a chronic debilitating disease in your 30s and 40s is really devastating, not only to the individual patient, but to their family, their community and to society as a whole" (Baltimore Sun, 3/19).

Eric Peterson, a cardiologist at Duke University Medical Center, wrote in an accompanying editorial that the study is "remarkably important" because it "shows you where having 20 years of uncontrolled blood pressure has effects, on kidney disease -- and on the heart," adding, "It wears it out" (New York Times, 3/19).

The study is available online. The accompanying editorial also is available online.