As most know, February is Black History Month, and we wish that this blog post will be an unmitigated celebration of all that African-Americans have pioneered in the health care field and the lives that have been saved as a result of their vision, invention and discoveries. In the end, though, this piece will contain some bitter irony because as much as we revel in all that African-American physicians and scientists have done to make our society healthier, we can never lose sight of the fact the black community still suffers disproportionately from a variety of chronic illnesses, including heart valve disease.
Successfully addressing this health disparity is one of our nation’s great health challenges.
Of course, the history of African-Americans in medicine – and, relevant to this blog, cardiac medicine in particular – is replete with daunting challenges being overcome. There was Daniel Hale Williams, who practiced medicine at a time in which blacks weren’t even allowed to be members of the American Medical Association, but who performed the first successful open heart surgery in the United States when he made the split-second decision to open the chest of a man who had been severely injured in a bar fight.
And then there was Otis Boykin in the mid-20th century, an electronics whiz who made parts for computers and guided missiles and, one day, invented a device that could be used to control heart pacemakers. And, more recently, there was Regina Benjamin, President Obama’s first Surgeon General, who used her office and to emphasize wellness and disease prevention and protected an unimaginable number of hearts by using her bully pulpit to focus attention on healthy foods, exercise and smoking cessation.
That brings us back to the distressing irony that African-Americans are at a much higher risk of developing heart disease, contract it earlier, and have poorer health outcomes. And, heart valve disease is no exception. Here are some of the alarming facts:
- According to an American Heart Association report, 44 percent of black men will incur heart disease in their lifetime compared to 37 percent of white men, and the same holds true for 49 percent of black women compared to 32 percent of their white counterparts.
- African-Americans get heart disease at a disproportionately early age. Between the ages of 45 and 64, black men have a 70 percent higher risk of heart failure, and black women a 50 percent greater risk, than white men and women.
One of the greatest dangers is posed by heart valve disease, a condition that is all too frequently undiagnosed and untreated. This disease can take different forms. If you imagine the heart’s four valves being akin to “gates” to the heart, sometime calcium deposits can cause the gates to not open all the way meaning that less blood flows into the heart. This is called stenosis. This makes the heart work harder, causing feelings of fatigue and breathlessness that are too often ascribed to aging instead of a cardiac condition.
Conversely, sometimes the valves don’t close all the way, leading to blood flowing backward in the heart. This is often described as a “leaky valve” or “regurgitation” and can lead to congestive heart failure and other complications. Again, this is a condition that is frequently undiagnosed because the individual may not even be aware a problem exists.
The good news is that heart valve disease can be treated successfully. Surgery is required to fix valves, and before surgery heart valve symptoms may be addressed with medication with vigilant monitoring for any declines in function. Although surgical outcomes for treating heart valve diseases are similar for African Americans and whites, African Americans are less likely to undergo surgery as a result of not being evaluated for surgery or declining to pursue surgical repair or replacement. Clearly, greater awareness and counseling is needed that’s where a significant challenge lies.
According to a study commissioned by the Alliance for Aging Research, the public at large has an insufficient awareness of heart valve disease, but this is acutely true for minority populations. According to the nationwide survey conducted for the study, only 18 percent of African-Americans were familiar with heart valve disease. This is a particularly dangerous finding, given the high propensity of black Americans to be afflicted with cardiovascular illnesses.
As we think about Black History Month, perhaps the greatest tribute we could pay to the African-American medical giants of our past is to take steps to ensure that all people, regardless of socioeconomic category, have longer, healthier lives as a result of their groundbreaking work.
We can all do our part. Please add your voice to those calling for better heart health for all Americans and fewer lives shortened by heart valve disease. You can sign up here to be part of effort that respects the progress of our past and builds a brighter future.