Why Blacks should prioritise their heart conditions

Emeh Joy
By Emeh Joy

Basic medical scientist, health research writer with experience writing for health brands like Dentistry Brands LLC and KompleteCare.

As less infectious as Heart disease might sound, Heart diseases are the leading cause of death in Sub-Saharan Africa. This is more reason why Blacks should prioritise their cardiovascular health.

A black man riding a motorcycle: The Blacks are at a higher risk of developing heart diseases and should prioritise their heart health

Heart disease is any medical condition that affects the cardiovascular system. The cardiovascular system consists of the blood vessels (arteries, veins and capillaries) and the heart, which pumps blood to all body parts.

Diseases that affect the cardiovascular system range from manageable chronic diseases to life-threatening conditions.

The Centers for Disease Control and Prevention (CDC) reported that one person dies every 36 seconds in the United States due to cardiovascular disease.4 It also stated that the condition is the leading cause of death for men and women. 

Anybody (including infants) can develop a heart condition, irrespective of race and ethnic group. However, research has shown that Blacks have a higher tendency of developing heart diseases. For this and other reasons discussed in this article, Blacks must prioritise their cardiovascular health.

What are cardiovascular diseases?

Cardiovascular diseases are a group of diseases that affect the heart or blood vessels. There are different types of cardiovascular diseases, and they affect the heart and blood vessels in different ways.

Some common types of cardiovascular diseases include:

  • Coronary artery disease (CAD): CAD is the most common type of heart disease and the leading cause of adult deaths in the United States.10 It is caused by the hardening and narrowing of the arteries that supply blood to the heart. The arteries narrow and harden due to the build-up of cholesterol and other materials in their inner walls.
  • Arrhythmia: This is an irregular beating of the heart caused by malfunctioning electrical impulses that control the heartbeat. It could occur as a rapid heartbeat (tachycardia) or slow heartbeat (bradycardia).
  • Heart attack: This is also known as myocardial infarction. It occurs when blood flow to the heart is interrupted by a blood clot or plaque, causing damage to the heart muscle.
  • Heart failure: Heart failure is a condition that affects the heart's pumping ability. In this case, the heart is working; however, it is not pumping blood efficiently. Other heart conditions like arrhythmia, high blood pressure and CAD can cause heart failure.
  • Cardiac arrest: This is when the heart malfunctions and stops beating. It is an electrical problem caused by the disruption of the heart's rhythm. 
  • Congenital heart defects: This is a heart problem that is developed from birth. A congenital heart defect could be a septal defect, atresia, a structural heart issue or atypical heart valves. A congenital heart defect can cause heart murmurs which are common in children.2

Genetics can also contribute to cardiovascular issues, e.g. hypertrophic cardiomyopathy tends to be an inherited problem. This is why doctors also ask about a patient's family history while diagnosing a cardiovascular problem.

Symptoms of heart disease

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Some cardiovascular diseases are with symptoms, while others are without symptoms. Signs that may indicate a heart problem include:

  • Difficulty in breathing
  • Fatigue and lightheadedness
  • Angina (severe pain in the chest)
  • Oedema (swelling of the body/body part due to fluid retention). 
  • Heart palpitations
  • Sweating
  • A choking sensation
  • An irregular heartbeat
  • Swollen ankles

In children and infants, you should watch for murmurs, cyanosis (a bluish discolouration of the skin) and inability to play around (exercise). These may be signs and symptoms of heart disease. 

Blacks and cardiovascular diseases

According to the U.S Department of Health and Human Services Office of Minority Health, African Americans were 30% more likely to die from heart disease than non-Hispanic Whites in 2018.15

The report also showed more non-Hispanic Black Americans had high cholesterol levels and high blood pressure compared to the Non-Hispanic Whites.

Sub-Saharan Africa has been more focused on combating diseases like tuberculosis, malaria and HIV/AIDS, which have indeed ravaged the region.  Substantial amounts of money have been thrown into fighting these infectious diseases.

However, while clinicians, governments and stakeholders put all resources into fighting infectious diseases, chronic, non-communicable diseases like hypertension have subtly but rapidly increased in both morbidity and mortality.

It has gotten so bad that today, cardiovascular diseases have become the number one cause of death in Sub-Saharan Africa in adults over 30 years of age.6  In fact, high blood pressure is said to affect nearly one in two Africans over 25 years of age.13

Why blacks have higher tendencies of developing heart diseases

You must ask, why do blacks have a higher tendency of developing cardiovascular diseases?

Different factors have contributed to why blacks are at a higher risk of developing cardiovascular diseases. Gene plays a role here. Studies have shown that genes can influence the risk of heart diseases in different ways.

A variation in a single gene (mutation) can affect the likelihood of developing cardiovascular diseases in different ways, such as changing the way the heart cells communicate or altering the strength of blood vessels.

A study has identified some genes that may play a role in the genetics of hypertension. It found that genes regulating the renin-angiotensin-aldosterone system (a hormone system that regulates blood pressure and fluid balance) such as SCNN1B, GRK4 and CACNA1D play a role in the genetics of hypertension. And the genes can be associated with hypertension in Africans.16

Also, when it comes to factors like race and gender, there are lots of differences. One of the most striking differences is the tendency of Blacks to develop high blood pressure compared to the white race.5 

High blood pressure is one of the leading causes of heart disease. Progress has been made in recent years to control cases of high blood pressure; however, a large proportion remains uncontrolled. 

Obesity prevalence also differs among races. Reports have shown that Black women have the highest risk of being severely obese (16%), followed by Hispanic women (10%) and White women (9%).14

Obesity goes beyond a cosmetic issue. It is a medical condition that increases the risk of other diseases such as diabetes, high blood pressure and heart disease. 

These (hypertension and obesity) are the strongest drivers of cardiovascular diseases in Africa. The worst is that hypertension goes undiagnosed and untreated while little or no attention is paid to obesity. 

The typical Black lifestyle doesn’t support a healthy heart

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To better understand how Black’s lifestyle can affect their heart health, let’s paint the picture of a typical Black man’s lifestyle using Nigeria as a case study.

Nigeria is a great nation located in West Africa. The country prides itself as the “Giant of Africa”. Its people appreciate culture and embrace heritage. They are strong people that believe there is dignity in labour.

For Nigerians, life is about survival. They sleep every day thinking of how to be successful in their various careers and wake up every day with the mindset to continue their toiling where they stopped the previous day.

Every man in Africa is seen as a provider, whether married with a family or not. Once you are born a male and have gotten to a certain age, you are expected to start working and earning money to provide for your immediate and extended family.

The Black woman is not left out in the struggle. For the woman, high expectations are placed on her to keep the family together, take care of the home and in some cases, work to bring in more money.

How things are structured in most African homes makes it harder for the Black man to relax, go on vacations or seek luxury like his White counterpart. For most Africans, relaxing and having fun is a luxury they can't afford or simply put- 'a waste of time'. This leaves them always under pressure and stress, which is bad for the heart.

Studies have shown that stress can increase the risk of heart diseases.8 When the body is stressed, stress hormones (primarily cortisol) are released. High levels of cholesterol in the body can increase blood sugar, blood cholesterol and blood pressure. These can lead to heart attack or stroke. 

Also, most Nigerians tend to skip physical activity. Exercises like running and playing football are left for the children and teenagers while the adults (who have higher risks of developing heart issues12) work from Monday to Saturday and go out on Sundays to watch football with friends over beer bottles. 

An epidemiological study showed the level of insufficient physical activity in Nigeria.1 According to the study, the prevalence of physical inactivity in Nigeria is about 52%. Women have a higher prevalence of physical inactivity (55.8%) compared to men (49.3%).

The heart is a muscle and responds to exercise like other muscles in other parts of the body. Research has shown that being physically active is a crucial step to maintaining a healthy heart.7 Lack of physical exercise among a more significant number of the population could increase the population’s risk for heart disease. 

Another factor that could contribute to the higher risk of health disease amongst Black is eating lifestyle. Brookings published an article titled, “Black and Hispanic Americans at higher risk of hypertension, diabetes obesity: Time to fix our broken food system”, depicting that food contributes to the development of cardiovascular diseases like hypertension.

Africa’s staple foods include cassava, yam, green bananas and plantain, millet and vegetables. These foods are not bad for the health if prepared healthily. A 2017 study showed that Africans are now dumping the more nutritious foods for the less nutritious ones that contain more added fats, salt and sugar.11

Unhealthy meals can cause medical conditions like diabetes and coronary heart disease. Also, overeating high-calorie staple foods without working out can lead to weight gain and obesity. Obesity increases the risk of cardiovascular diseases, particularly coronary heart diseases and heart failure.3 

Most Blacks are ignorant of healthy living

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"More than 50% of Black women over the age of 20 have high blood pressure. And then add to the fact that 30% of Black Americans typically die or are more likely to die than non-Hispanic Whites", said Stephanie Johnson, AMA'S Vice President of Communications and Product strategies, during the association's podcast.

"It is astounding to hear. And it is a lot of factors, structural in nature, access to quality care, diversity in our physician force", she added. 

As one way to tackle the issue, Johnson suggested that Blacks should be willing to send their children to medical school so there will be more people in the health scene taking care of the growing diverse population and creating health awareness. 

Many Blacks don't understand the importance of eating and living healthy. They place less value on exercise and healthy diets, which are important aspects of healthy living.  

Many people living with hypertension are unaware of their health status, and hypertension is one of the leading causes of heart disease. An article in the journal 'Hypertension' clearly points that physical inactivity, poor diet and excessive alcohol intake alone or in combination are the major underlying cause of hypertension.

More awareness needs to be created. People should be made to understand that exercising and eating right are key preventive care strategies. Exercising and adopting the right dietary lifestyle keeps the heart healthy and improve the quality of life.

Blacks should also learn to monitor their health. Monitoring helps people pay attention to their vital signs. There are six main vital signs: blood pressure, pulse, respiration, temperature, height, and weight.9

Watching your weight and blood pressure is a crucial strategy for taking care of your heart. Both affect your heart health and show the status of your body's vital functions. 

References

  1. Adeloye, D., and Ige-Elegbede, J. et al. (2021).  Epidemiology of physical inactivity in Nigeria: a systematic review and meta-analysis. Journal of Public Health, fdab147, https://doi.org/10.1093/pubmed/fdab147
  2. American Heart Association (AHA). (n.d.) Symptoms and Diagnosis of Congenital Heart Defects. https://www.heart.org/en/health-topics/congenital-heart-defects/symptoms--diagnosis-of-congenital-heart-defects 
  3. Carbone, S., Canada, J. M., Billingsley, H. E., Siddiqui, M. S., Elagizi, A., & Lavie, C. J. (2019). Obesity paradox in cardiovascular disease: where do we stand?. Vascular health and risk management, 15, 89–100. https://doi.org/10.2147/VHRM.S168946 
  4. Centres for Disease Control and Prevention (CDC). (2021, September 27). Heart Disease Facts. https://www.cdc.gov/heartdisease/facts.htm 
  5. Fuchs, F.D. (2011). Why Do Black Americans Have Higher Prevalence of Hypertension? An Enigma Stil Unsolved. Hypertension, 57: 379-380. https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.110.163196 
  6. Gaziano, Thomas, A. (2005). Cardiovascular Disease in the Developing World and Its Cost-Effective Management. Circulation, (112): 3547-3553. https://doi.org/10.1161/CIRCULATIONAHA.105.591792 
  7. Harvard Health Publishing. (2021, February 15). The Many Ways Exercise Helps Your Health. https://www.health.harvard.edu/heart-health/the-many-ways-exercise-helps-your-heart 
  8. John Hopkins Medicine. (n.d.). Risk Factors for Heart Disease: Don't Underestimate Stress. https://www.hopkinsmedicine.org/health/wellness-and-prevention/risk-factors-for-heart-disease-dont-underestimate-stress 
  9. McCarthy, F.M. (1980). Vital Signs--the-Six-Minute Warnings. Journal of the American Dental Association (1939), 100(5): 682-691. https://pubmed.ncbi.nlm.nih.gov/6154071/ 
  10. MedlinePlus. (n.d.) Coronary Artery Diseases. https://medlineplus.gov/coronaryarterydisease.html 
  11. Muyonga, J. and Nansereko, S. et al (2017). Traditional African Foods and Their Potential to Contribute to Health and Nutrition: Exploring the Nutrition and Health Benefits of Functional Foods, Pgs: 27. DOI: 10.4018/978-1-5225-0591-4.ch015. SN  - 9781522505921. https://www.igi-global.com/chapter/traditional-african-foods-and-their-potential-to-contribute-to-health-and-nutrition/160605
  12. NIH National Institute on Aging (NIA). (2018, June 1). Heart Health and Aging. https://www.nia.nih.gov/health/heart-health-and-aging 
  13. Ouyang, Helen (2014). "Africa's Top Health Challenge: Cardiovascular Disease." The Atlantic. https://amp.theatlantic.com/amp/article/381699/ 
  14. Reeves, R.V. and Smith, F. (2020, August 7). "Black and Hispanic Americans at Higher Risk of Hypertension, Diabetes, Obesity: Time to Fix our Broken Food System." Brookings. https://www.brookings.edu/blog/up-front/2020/08/07/black-and-hispanic-americans-at-higher-risk-of-hypertension-diabetes-obesity-time-to-fix-our-broken-food-system/ 
  15. U.S Department of Health and Human Services Office of Minority Health. (2021, February 11). Heart Disease and African Americans. https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=19 
  16. Zilbermint, M., Hannah-Shmouni, F., & Stratakis, C. A. (2019). Genetics of Hypertension in African Americans and Others of African Descent. International journal of molecular sciences, 20(5), 1081. https://doi.org/10.3390/ijms20051081