Michigan State Representative Has Put Her Heart In To Improving Black Health

by Kenny Anderson

In Michigan African-Americans have a real advocate for healthy equity in state government, House Member State Representative Brenda Carter has been a forefront voice in addressing the state's racial health disparities.

Michigan State Representative Brenda Carter

Those African-American leaders who lead in improving Black health are special because they realize the most important thing we possess is our health!

Representative Carter a Democrat has especially pushed hard for policies to improve the health status of Black women and children in reducing high rates of maternal mortality and infant mortality. 

Not only has Rep Carter pushed hard for health equity policies, she works closely with local individuals and groups including veterans who are engaged in community-based preventative health initiatives.

Rep Carter has tirelessly highlighted the unacceptable high levels of chronic diseases among African-Americans particularly heart disease; she’s challenged Blacks to take the lead in health self-improvement by reducing internal health detriments and living healthier lifestyles.

Black Hearts Matter salutes Michigan State Representative Brenda Carter's dedicated efforts to improve African-American health.    

The Heart the Most Critical Electric Organ

by Kenny Anderson

The Creator 'Source of Creative Intelligence' created the foundation of the human body as an 'electrical system'. The nervous system is the body's electrical wiring, a complex collection of nerves. 

When we look at the nervous system, we should conclude that the designer of the human body must have had an intricate knowledge of electronics and must have known how to harness electrical energy to change it into other forms of energy.

The electrical nervous system and the heart

The sympathetic and parasympathetic nervous systems are opposing forces that affect your heart rate. Both systems are made up of very tiny nerves that travel from the brain or spinal cord to your heart.

The sympathetic nervous system is triggered during stress or a need for increased cardiac output and sends signals to your heart to increase its rate. The para -sympathetic system is active during periods of rest and sends signals to your heart to decrease its rate.

Our Hearts Electricity

The heart is the most powerful source of electromagnetic energy in the human body, producing the largest rhythmic electromagnetic field of any of the body's organs. The heart's electrical field is about 60 times greater in amplitude than the electrical activity generated by the brain.

For our hearts to beat continually the heart muscle has to contract in a uniform way. Contraction starts when an electrical message going out to your individual heart muscle cells. The electrical signal starts in a group of cells at the top of your heart called the sinoatrial (SA) node. The signal then travels down through your heart, triggering first your two atria and then your two ventricles.

The heartbeat happens as follows:

1. The SA node (called the pacemaker of the heart) sends out an electrical impulse.

2. The upper heart chambers (atria) contract.

3. The AV node sends an impulse into the ventricles.

4. The lower heart chambers (ventricles) contract or pump.

5. The SA node sends another signal to the atria to contract, which starts the cycle over again.

Although the heart can operate independently, the heart responds to many factors in your body; there are a number of feedback systems between your heart, your brain, and other organ systems that help maintain a normal heart rate and rhythm.

The field of neurocardiology numerous research has shown that the heart sends more information to the brain than the brain sends to the heart. And the brain responds to the heart in many important ways. This research explains how the heart responds to emotional and mental reactions and why certain emotions stress the body and drain our energy.

As we experience feelings like anger, frustration, anxiety and insecurity, our heart rhythm patterns become more erratic. These erratic patterns are sent to the emotional centers in the brain, which it recognizes as negative or stressful feelings. These signals create the actual feelings we experience in the heart area and the body. The erratic heart rhythms also block our ability to think clearly.

Many neurocardiology studies have found that the risk of developing heart disease is significantly increased for people who often experience stressful emotions such as irritation, anger, frustration, etc. 

These emotions create a chain reaction in the body stress hormone levels increase, blood vessels constrict, blood pressure rises, and the immune system is weakened. If we consistently experience these emotions, it can put a strain on the heart and other organs, eventually leading to serious health problems and death.

Heart Disease And Black Women

Heart disease disproportionately affects Black women. Importantly, Black women are less likely than white women to be aware that heart disease is the leading cause of death.

Major highlights of Black women and heart disease:

*Cardiovascular diseases kill nearly 50,000 Black women annually.

*Of Black women ages 20 and older, 49 percent have heart diseases.

*Only 1 in 5 Black women believes she is personally at risk.

*Only 52 percent of Black women are aware of the signs and symptoms of a heart attack.

*Only 36 percent of Black women know that heart disease is their greatest health risk.

Magnesium and Black Hearts

by Kenny Anderson

Magnesium is essential to heart health and the prevention of cardiovascular disease. Magnesium is needed to support the electrical activity of the heart, keeping the heart beating over 30 million times a year. Magnesium is also needed for blood pressure regulation and heart rhythm control. 

Magnesium deficits have been linked with cardiovascular disorders: high blood pressure, heart rhythm problems such as atrial fibrillation, cholesterol-clogged coronary arteries, painful spasms of coronary arteries, and sudden cardiac arrest (heart attack). 

Numerous studies show that most Americans are not getting enough magnesium in their diet. Studies shows a staggering 68% of Americans do not consume the recommended daily intake of magnesium 310–420 mg and 19% of Americans do not consume even half of the government’s recommended daily intake of magnesium.

Research has shown that people with a higher intake of magnesium have a lower risk of heart disease. Studies have also revealed that the higher your blood level of magnesium the lower your risk of coronary artery calcification. 

Recent studies cite that low magnesium levels have been found to be the best predictor of heart disease, contrary to the traditional belief that cholesterol or saturated fat play the biggest roles.

Additionally, it has been discovered that higher levels of magnesium are associated with lower levels of the inflammatory marker C-reactive protein which is linked to heart problems. Blacks have the highest rate of heart problems in America; over 40% of Black men and women have heart disease.

Blacks High Level of Chronic Stress and Low Levels of Magnesium

Blacks in America definitely are not getting enough magnesium due to poor diets (over consumption of processed foods) and the depletion of magnesium due to chronic stress. 

Blacks are the most oppressed racial group in America, suffering more chronic stress from institutional racism. Chronic distress includes unending feelings of despair - hopelessness, anger, shame, worry, and grief; poverty, family dysfunctional stress, traumatic experiences, experienced and perceived racial discrimination, neighborhood stress, daily stress, acculturative stress, and environmental stress.

Indeed, chronic stress depletes your body of magnesium leading to magnesium deficiency; the greater your level of stress, the greater the loss of magnesium. Living under constant conditions of mental or physical stress causes magnesium to be released from your blood cells and goes into the blood plasma; from there it's excreted into the urine. 

The lower your initial magnesium level is, the more reactive to stress you become, and the higher your level of adrenaline in stressful situations. Higher adrenaline causes greater loss of magnesium from cells creating a vicious cycle.

Heart health benefits of magnesium include but are not limited to:

*Preventing arrhythmias (irregular heartbeats such as atrial fibrillation)

*Keeping blood vessels healthy

*Supporting normal blood vessel dilation and contraction

*Helping to reduce damage to the heart from oxidative stress

*Boosting the good HDL cholesterol

*Protecting against Type 2 Diabetes

*Anti-inflammatory action

What Are Cardiac Symptoms of a Magnesium Deficiency?

*Heart arrhythmias like atrial fibrillation, PAC’s and PVC’s.

*Elevated blood pressure

*Inflammation

*Blood sugar imbalances

What Are Other Symptoms of a Magnesium Deficiency?

*Insomnia

*Fatigue

*Muscle pain

*Anxiety or stress

*Headaches and migraines

Some Foods High in Magnesium

*Fatty Fish (salmon, mackerel, halibut) 

*Greens (collard, mustard, turnips; kale, spinach)

*Bananas

*Nuts (Brazil nuts, almonds, cashews) 

*Seeds (flax, pumpkin, chia)

*Legumes (beans)

*Avocados

What Are the Best Forms of Magnesium for the Heart?

Of the nine common forms of magnesium there are five that are imperative to heart health. These are magnesium malate, magnesium citrate, magnesium taurinate, magnesium bisglycinate chelate, and magnesium orotate:

*Magnesium Malate: This form consists of magnesium combined with elemental malic acid. This type of magnesium is well absorbed and supports energy levels. Malic acid supports energy production in cells and aids in detoxing heavy metals from the body. It is a highly bioavailable form to support blood pressure, heart rhythm, inflammation and nerve function.

*Magnesium Citrate: This form is magnesium bound to citric acid. It has a high absorption level. It is good for sleep and heart muscle relaxation. It aids in supporting digestion and improving constipation. Again, it is highly bioavailable to support blood pressure, heart rhythm and the heart muscle.

*Magnesium Taurinate: This form, consisting of magnesium and the amino acid taurine, is highly bioavailable to the cells. This form is exceptional for the heart as both the magnesium and taurine can improve the function of the heart muscle. This form can increase ATP (energy) production in the cell, which protects the heart muscle. This type also reduces blood pressure and increases insulin sensitivity, further protecting the heart.

*Magnesium Bisglycinate: This form of magnesium consists of magnesium and the amino acid glycine. It has a high absorption rate. It is also good for sleep and muscle relaxation. It has a calming effect on the nervous system.  This type is chelated and stable so it has a non-laxative effect. Due to its high absorption level, it is helpful in regulating blood pressure, heart rhythms and the cellular activity of the heart muscle.

*Magnesium Orotate: Magnesium orotate is a compound made up of magnesium and orotic acid. This is one the most effective forms of magnesium for heart health. This form can actually penetrate cell membranes and deliver magnesium to the innermost compartments of the cells. It is needed for heart health as it can deliver magnesium to these cells and help with recovery of these tissues. It is also the best way to reverse magnesium deficiencies. Together, all five of these forms work to support the electrical activity of the heart and aid in normal blood pressure regulation.

As Black folks we must understand that our heart muscles has one of the highest needs for magnesium; our hearts need high-quality magnesium to function properly. Due to poor diets and high levels of chronic stress we need to request that our Primary Care Physicians do blood work to check our magnesium levels. Moreover we need to learn and practice stress management, increase eating foods with high levels of magnesium, or take magnesium supplements.  

Post-Traumatic Stress Disorder Strikes One in Eight Heart Surgery Patients

By Anne Curley

Post-Traumatic Stress Disorder (PTSD) usually is associated with military personnel traumatized by combat or people who’ve been victimized by violent crime or sexual assaults.

But new study finds that one in eight patients develop PTSD after experiencing a heart attack or other major heart event. The study, published online in PLoS One, also reveals that heart patients who experience PTSD face double the risk for another heart event or dying within one to three years, compared to heart patients who do not experience PTSD.

Scientists from Columbia University Medical Center performed the first meta-analysis of studies examining PTSD induced by major heart events. The studies included almost 2,400 patients who experienced acute coronary syndrome or ACS, an umbrella term medical professionals use to describe any condition that reduces blood flow to the heart, including heart attacks and unstable angina.

“Everybody is expected to have some disruption after a life threatening event such as a heart attack,” explained lead study author Donald Edmondson, assistant professor of behavioral medicine at Columbia University Medical Center, “but after a month we expect people to mostly get back to normal.” Edmondson said their research focused on studies of patients who experienced symptoms of PTSD more than one months after their heart event.

“These studies measured PTSD symptoms intrusive thoughts about the heart attack – out of nowhere that sort of fight or flight response to these memories. People also have nightmares about the event, they have sleep disruptions, they actively avoid thinking about the heart attack, they try to manage their thoughts,” said Edmondson.

More than 1.4 million people in the U.S. are discharged each year from hospitals after suffering acute coronary syndrome, explained Edmondson, If 12% of those patients experience clinically significant symptoms of PTSD, that means that 168,000 patients could experience PTSD each year after heart events.

While medical professionals are keenly aware of the association that has been shown between depression and heart attacks, Edmondson believes that making patients, their families and medical professionals aware of the incidence of PTSD after heart events is critical.

Edmondson said when he’s discussed findings about PTSD with cardiologists, they’ve told him 'I thought these were funny depression symptoms. I knew there was something wrong here but I didn’t have a language for it.'  

Edmondson said that while PTSD and depression often travel together, "PTSD symptoms are unique – the experience of intrusive thoughts, the nightmares, the inability to shake thinking certain thoughts, the fight or flight symptoms are unique to PTSD. For a patient or a cardiologist who’s not looking for PTSD, once you know the symptoms, they sort of jump out and they’re unique to PTSD."

“Despite the variation in the estimates of the prevalence PTSD appears to be a reasonably common occurrence after ACS and seems to be associated with worse outcomes,” said Dr. Gordon F. Tomaselli, president of the American Heart Association.  "Further study is warranted but practitioners need to be alert to the possibly of PTSD after ACS and should institute treatment.”

“Physicians and patients have to be aware that this is a problem. Family members can also help,” said Edmondson.  "There are good treatments for people with PTSD,” Edmondson noted, explaining that the best treatment is an “exposure based talk therapy," in which the patient talks about the traumatic experience, reliving it in an effort to desensitize them to the event.

Study Finds Black Communities Suffer from Higher Comparative Rates of Sudden Cardiac Death Than White Ones

By Kiersten Willis

New research from the American Heart Association reveals an explanation as to why Black communities see higher rates of sudden cardiac arrest death especially between women than white ones.

Findings from a study by the Atherosclerosis Risk in Communities (ARIC) revealed that by age 85 Black men account for 9.6 percent of people who suffered sudden cardiac deaths, while 6.6 percent of sufferers were Black women. 

Comparatively, white men accounted for 6.5 percent of sudden cardiac arrest deaths, while white women made up 2.3 percent of such victims. These numbers show Black men had a sudden cardiac death rate nearly 48 percent higher than that of white men, while Black women’s death rate was 187 percent higher than white women’s.

The study, which was conducted over the course of nearly three decades and published in AHA’s journal Circulation, revealed that Blacks’ higher comparative rates are the results of differences at a cultural and socioeconomic level, including disparities in education and income. Additionally, risk factors like hypertension and diabetes are to blame.

The ARIC study collected its data by focusing on four American communities — the suburbs of Minneapolis, Forsyth County in North Carolina, Washington County in Maryland, and Jackson, Mississippi. White participants made up 11,237 of those reviewed, while 3,832 Black participants were involved in the research.

Yet despite the findings, which were discovered over a significant span of time, lead researcher Eliseo Guallar, Ph.D., acknowledged more studies need to be conducted.

“Low income and lack of education are associated with unhealthy behaviors, low disease awareness, and limited access to care, which could all contribute to poor outcomes,” Guallar said in a press release. “However, our understanding of the mechanisms for racial differences in sudden cardiac death is still incomplete and additional research is needed.”

Still, there are some solutions available to assist Black communities with combating the findings of the ARIC. Dr. Icilma Fergus, associate professor of medicine at Mount Sinai Medical Center in New York City, told Healthline that she’s working with communities in the area to teach them about how to spot and treat symptoms and promote heart health. 

Dr. Fergus co-founded and co-directs the Healthy Heart Series program, which provides workshops and training to assist people in learning simple ways to look after themselves and to prevent and heart disease and sudden cardiac arrest.

“It’s about creating a trusting situation where people learn from and gravitate to providers they trust, gain the knowledge, and ultimately do it for themselves,” she said. “When I started working in central Harlem, I found that people weren’t as trustful of doctors at first. We started out with 10 or 20 people in the monthly workshops, now we have 90 on average.”

Along with taking proper medications, it’s also important for people to have access to healthier food options, which is not always the case in areas where food deserts are common. Such issues disproportionately affect Black communities. 

However, Fergus noted that getting ingredients for quality meals can be done through a community farmers market without resorting to an expensive health foods store.

Micro-vascular Angina: a Puzzling Form of Chest Pain and Unrecognized Danger

It's more common in women than men and often goes untreated

by Vinita Subramanya, M.B.B.S, M.P.H. and Erin Michos, M.D., M.H.S.

A type of cardiovascular disease known to physicians as micro-vascular angina affects the heart's tiniest arteries and causes chest pain. The disease is sneaky, in that it doesn't show up on traditional heart scans but is linked to serious health outcomes, like heart attacks. 

Here is what you need to know about micro-vascular angina, which is often unrecognized and under-treated and more common in women than men.

What Is Micro-vascular Angina?

When the oxygen supply to the heart muscle tissue cannot meet the heart's metabolic demand, it can sometimes (but not always) cause chest pain, known as angina. The more common form of angina is from blockages in the heart's arteries due to buildup of cholesterol plaque a condition called obstructive coronary artery disease that limits blood flow to the heart.

Physicians frequently evaluate people with chest pain by stress testing and sometimes with an angiogram a type of X-ray in which dye is injected into the heart's arteries to see blockages or narrowing. This test can help determine what type of treatment is needed.

But many individuals with angina don't show obstructions or blockages in their heart arteries when evaluated by an angiogram. This problem of chest pain without obstructive coronary artery disease or micro-vascular angina may be caused by problems with the small arteries of the heart instead of the large ones visualized in the traditional scans.

Mechanisms that contribute to micro-vascular angina aren't fully understood, but some potential causes have been identified. It can be due to temporary spasms of the larger heart arteries or from abnormal functioning of the endothelial cells that line the heart arteries.

Endothelial cells release chemicals that relax and contract the small arteries. This chemical release can become imbalanced in a diseased heart. Risk factors such as smoking, diabetes and inflammation can often cause these endothelial cells to malfunction. Patients with micro-vascular angina may also have an increased sensitivity to pain due to certain substances released from these cells.

What Are the Signs and Symptoms?

Micro-vascular angina, formerly known as cardiac syndrome X causes a constellation of symptoms and signs that include chest pain during physical exertion, signs of reduced blood supply to the heart as determined by stress testing or advanced cardiac imaging, and normal-appearing arteries on an angiography of the heart.

Micro-vascular angina diagnosis is often missed because it can show up in a more unusual fashion than chest pain from obstructive coronary disease. For example, micro-vascular angina episodes can occur during times of mental and emotional stress or even at rest, rather than just physical exertion; episodes can last longer than those from obstructive coronary disease, and they respond less well to standard therapies, like nitroglycerin.

Micro-vascular angina symptoms can sometimes be falsely blamed on other causes, like stress and anxiety, panic attacks or gastrointestinal troubles. For many years during chest pain assessments, physicians only looked for signs of obstructive coronary artery disease, and they dismissed chest pain if they found no obstruction. This led to missed opportunities for implementing the appropriate treatments for this condition.

Both men and women can develop micro-vascular angina, but it's much more common in women. Among patients with stable chest pain about 41 percent of women versus 8 percent of men show no large artery obstructions on angiograms.

Why Is Micro-vascular Angina Serious?

While micro-vascular angina is usually a stable condition, women are twice as likely as men to have normal-looking heart arteries (without apparent blockages) when they actually have a heart attack. This unusual type of heart attack is called myocardial infarction with non-obstructed coronary arteries, or MINOCA.

Spasms in the blood vessels can be one potential cause. In many instances, a special type of heart ultrasound can confirm plaque in the heart arteries that had eroded or ulcerated. These heart arteries aren't 'normal' despite the absence of blockages.

The Women's Ischemia Syndrome Evaluation, sponsored by the National Heart, Lung, and Blood Institute, was a landmark study that began back in 1996 and enrolled over 900 women with signs and symptoms of heart disease who underwent a coronary angiogram.

The outcomes of these women followed for more than a decade have contributed much of the knowledge that we know today about micro-vascular angina, including some of the mechanisms behind this puzzling condition and its long-term risks. 

For example, the WISE study found that the heart's arteries react with abnormal patterns of narrowing and relaxing in women with micro-vascular angina. More importantly, the WISE study concluded that even without evidence of major heart artery obstructions, micro-vascular angina is worrisome.

Patients with angina but without obstructed arteries still have increased rates of heart attacks, strokes, heart failure and death compared to women without angina. This is magnified among women with more cardiovascular risk factors. Micro-vascular angina increases death rates by 1.5-fold. People with angina also have higher hospital readmission rates for chest pain and repeat coronary angiographies.

The WISE study led to great improvements in diagnosing and treating micro-vascular angina, but gender differences still exist in the clinical outcomes, with women still being under-diagnosed and under-treated.

How Do We Test for Micro-vascular Angina?

Since we can't determine the causes of chest pain solely from the symptoms, we look to additional ways of diagnosing angina. Physicians classify symptomatic women by their risk as either low, intermediate or high, and evaluate them based on cardiovascular risk factors.

Low-risk women don't usually need further testing. Low to intermediate and intermediate-risk women should be further evaluated using an exercise treadmill test that measures a woman's exercise capacity and an electrocardiogram that measures electrical activity of the heart.

Intermediate to high-risk women with an abnormal ECG will need further imaging using any of the following techniques: myocardial perfusion imaging (or nuclear stress testing), stress echocardiography and cardiac MRI or cardiac CT-angiography.

High-risk women may be given a traditional coronary angiogram which may even be paired with an invasive test considered a gold standard the coronary flow reserve measurement. The coronary flow reserve test measures how much the heart arteries can dilate and increase blood flow above the normal volume when given a specific drug that relaxes the arteries. Revealing the exact cause of the micro-vascular dysfunction requires more in-depth testing.

How Do We Treat Micro-vascular Angina?

An important step to improve outcomes among women with micro-vascular angina is to recognize that they are at risk for some of the same outcomes as people with obstructive coronary disease. Physicians' treatment goals include a combination of strategies aimed to both increase blood flow and reduce workload in the heart.

While there aren't set regimens to treat micro-vascular angina, two therapeutic mainstays use medications that aim to improve chest pain and prevent plaque buildup in the arteries. Responses to treatments aren't consistent among men and women and may be related to the differences in the disease mechanisms. Anti-angina medications are used to improve symptoms of chest pain. 

These include beta blockers that improve the heart's blood flow by reducing its workload, calcium channel blockers that improve the blood flow and decrease blood pressure (thereby further reducing the workload) and nitroglycerin that works to improve blood flow. 

Aspirin prevents clot formation and decreases inflammation. Other newer drugs act on the heart's cellular processes and improve their functioning during temporary periods of low blood flow.

Other medications to treat micro-vascular angina include statins that lower cholesterol levels and prevent cholesterol from building up in the arteries, and the angiotensin converting enzyme inhibitors that improve the function of the endothelial cells lining the heart's arteries. 

Newer therapies under investigation include the class of drugs known as phosphodiesterase inhibitors that act at the cellular level and transcutaneous electrical nerve stimulation, both of which improve arterial blood flow.

How Do We Prevent Micro-vascular Angina?

The well-established (and largely preventable) risk factors that contribute to obstructive coronary disease such as high blood pressure, high cholesterol, diabetes, smoking and sedentary lifestyle are just as important for developing micro-vascular angina. 

Autoimmune conditions like rheumatoid arthritis and lupus may also raise the risk of developing micro-vascular angina. And young women with lower than normal levels of estrogen are at risk. 

Prevention strategies include reducing one's risk through appropriate medical and lifestyle changes, like controlling high blood pressure, cholesterol and blood sugar levels. Improvements in diet and physical activity levels can go a long way in reducing micro-vascular angina frequency.

People should eat a diet rich in omega-3 fatty acids, fruits, vegetables and whole grains, and minimize processed foods and foods with higher saturated fat, sodium and refined sugars. 

It's important to maintain a healthy weight and better manage stress levels through physical activity, stress management, relaxation programs, and meditation. Quitting smoking also should be a top priority.

Take-Home Points:

1) Micro-vascular angina is a form of chest pain due to abnormalities in the tiny arteries of the heart that cause decreased blood flow.

2) Since micro-vascular angina occurs in the absence of blockages or obstructions in the large heart arteries, it is often under-recognized and under-treated.

3) If you have chest pain after exerting yourself and get an abnormal result on a stress test but have no evidence of blockages on an angiogram, it is likely you have micro-vascular angina.

4) Women have this condition more often than men, and their symptoms can be different from men's symptoms.

5) People with micro-vascular angina have an increased risk of heart attacks and death in the next five years compared to patients without angina symptoms.

6) Controlling risk factors, such as not smoking, as well as managing blood pressure, blood sugar and cholesterol and other blood fats, are important for preventing and controlling symptoms of this disease.

7) Eating a healthy diet and getting plenty of physical activity are also very important for preventing and treating micro-vascular angina