High Rate of Early Heart Failure Seen in Blacks

ByABC News
March 18, 2009, 11:02 PM

Mar. 19 -- WEDNESDAY, March 18 (HealthDay News) -- Blacks tend to develop heart failure 20 years earlier than whites, a long-running study shows.

"What we found is that [early] heart failure occurs almost exclusively among blacks, and it is not a rare occurrence," said Dr. Kirsten Bibbins-Domingo, lead author of a report in the March 19 issue of the New England Journal of Medicine. "It affects one in 100 in their 20s and 30s. What this means is that the incidence of heart failure among blacks in their 20s and 30s is that of whites in the 40s and 50s."

The study, which enrolled 5,115 then-healthy young people in four U.S. cities "was initiated by the National Heart, Lung, and Blood Institute to understand how heart disease develops in young people," said Bibbins-Domingo, an assistant professor of medicine at the University of California, San Francisco, and co-director of the Center for Vulnerable Populations at San Francisco General Hospital. The study is just entering its 25th year, she noted.

In the first 20 years, 27 participants developed heart failure, the progressive loss of the ability to pump blood. All but one were black. And while the study did not exclude such factors as genetics and socioeconomic status as potential causes of the difference, it clearly showed a higher incidence of two major risk factors, high blood pressure and obesity, among blacks.

"If you look at blacks and whites at the beginning of the study, they were remarkably similar in risk profiles," Bibbins-Domingo said. The higher incidence of the two major risk factors soon emerged.

"Those risk factors for heart failure were already present in young adults, and they made themselves felt 20 years later," she said.

Some association was found between lower education levels and the risk of future heart failure, Bibbins-Domingo said. But the overriding link was with high blood pressure and obesity.

"From other work, we know that young people are least likely to be aware that they have high blood pressure," she said. "If they do have high blood pressure, they are least likely to be in treatment, and if they are in treatment, they are least likely to have it under control."