Air Pollution Takes Greater Toll on the Hearts of Black Americans Than Whites

by Steven Reinberg

A new study reports that air pollution takes a greater toll on the hearts of black Americans than whites, in part because they often live in poorer areas with more pollution.

"The greater risk of death from heart disease among blacks, compared with whites, is partially explained by higher exposure to air pollution," said lead researcher Dr. Sebhat Erqou, a fellow in cardiovascular disease at the University of Pittsburgh.

The western Pennsylvania study looked at the relationship between heart disease and a component of air pollution known as fine particulate matter. Fine particulate matter (called PM2.5, which is about 40 times smaller than the width of a human hair) stems from factories, vehicles, power plants, fires and secondhand smoke.

Researchers found that blacks living in areas where this type of pollution is high have a 45 percent higher risk of heart disease and death from any cause than whites, even after taking into account other common risk factors.

But about one-quarter of that elevated risk was attributed to their greater exposure to dirty air, which correlated with poverty, Erqou said.

Blacks and other minorities more often live close to sources of environmental pollution, such as highways, the researchers said in background notes. As income and education increased, the impact of air pollution decreased, Erqou said.

Chronic exposure to air pollution has been associated with numerous ill effects, included elevated blood sugar, poorly functioning blood vessels, heart disease and death, he noted.

This study reflects, again, racial disparities that exist in medical outcomes, said Dr. Rachel Bond, associate director for women's heart health at Lenox Hill Hospital in New York City.

"Air pollution clearly has a detrimental effect on the black community disproportionate to the white community with respect to cardiac disease outcomes," said Bond, who was not part of the study.

Another New York specialist who was not involved with the research pointed to the broad role economic differences can play.

"Exposure to air pollution may be more of a factor of socioeconomic status than race itself, and there may be confounders such as smoking history, home environment and occupation, which can affect health," said Dr. Walter Chua. He's a senior pulmonary attending physician at Long Island Jewish Forest Hills.

For the study, Erqou and colleagues reviewed data on PM2.5 and black carbon, which is an ultrafine component of PM2.5, from a Pittsburgh-area air monitoring campaign.

The researchers combined that with information from an ongoing heart study involving more than 1,700 residents (average age 59) of western Pennsylvania.

Each year, participants complete questionnaires that ask about heart-related hospitalizations, heart attacks, acute coronary syndrome, stroke, angioplasty or death from heart disease.

Erqou's team found that greater PM2.5 exposure was associated with increased blood sugar, worse blood vessel function, and higher odds for problems such as heart attack and stroke, and death from all causes.

The investigators also found that compared with whites, blacks had significantly higher average exposures to PM2.5 and black carbon.

A weakness of the study is that it's limited to one city, so the findings might be different in other locales, Erqou said. Also, the study only found an association rather than a cause-and-effect link.

Chua said it would be interesting to look at other major cities, including New York and San Francisco, to see if these disparities still exist, given that those cities are more diverse, he said.

Meanwhile, "the push to maintain good air quality should still continue," Chua said.

Cigarette Smoking Raises Heart Failure Risk in African-Americans

by Anne Harding

Cigarette smoking sharply increases the risk of heart failure in black men and women in the U.S., according to a new study by senior author, Dr. Michael E. Hall, an associate professor of medicine at the University of Mississippi Medical Center in Jackson.

“These findings suggest if you have heart failure or you have risk factors for heart failure such as early markers for heart damage like a thicker heart or a weak heart, you should specifically be targeted for smoking cessation strategies,” said the study’s senior author Dr. Hall.

In heart failure, the muscles of the heart weaken and enlarge so the organ can no longer pump blood efficiently, leading to shortness of breath and water retention. Heart failure is most often the result of damage from coronary artery disease, a buildup of fatty material within the heart arteries associated with heart attack and stroke. High blood pressure, excess weight, infection and several other factors can also contribute to heart failure.

Cigarette smoking is clearly associated with coronary artery disease, but its relationship with heart failure is not as well known, especially among African Americans, Hall’s team writes in the journal Circulation.

Blacks in the U.S. have double the incidence of heart failure as other groups, the researchers note. While smoking in this community has declined, it is still at 18 percent of adults, they add.

To investigate the potential role of smoking in heart failure risk, the researchers analyzed data on 4,129 black adults in Mississippi who participated in the Jackson Heart Study. Their average age was 54, and all were free of heart disease when they enrolled. Twelve percent reported being smokers, 18 percent were ex-smokers and 70 percent had never smoked.

Compared to never-smokers, the smokers had more enlargement of the left ventricle, the heart’s main pumping chamber, and worse left ventricular function. Levels of a hormone released by the heart that indicates heart failure, called brain natriuretic peptide (BNP), were higher in smokers than never-smokers, and those levels increased with the intensity and duration of smoking.

Once the authors took factors associated with both smoking and heart failure, such as coronary artery disease, into account, they found that smokers were almost three times more likely than non-smokers to be hospitalized for heart failure during eight years of follow-up.

People who smoked at least 20 cigarettes a day saw their risk increase about 3.5-fold. Those who had smoked the equivalent of a pack or more a day for 15 or more years were twice as likely as never-smokers to be hospitalized for heart failure.

Physicians will typically ask patients with coronary artery disease about smoking, and urge them to quit if they do, Hall said in a telephone interview. But heart failure seems to be a less obvious cue to many doctors.

“We probably in the health community need to do a better job of recommending cessation strategies for people who have risk factors for heart failure,” Hall said. “If they have risk factors, they should be strongly counseled to quit, that should be a no-brainer.”

He acknowledged that lack of health insurance and other factors can be barriers to effective smoking cessation treatment. But the costs of drugs proven to help people quit have declined, Hall noted, and many are now available for less than a pack-a-day smoker spends in a month on cigarettes.

In future research, he and his colleagues plan to examine whether newer nicotine delivery devices, like e-cigarettes, have similar effects on the heart. 

Heart Health Disparities Takes a Toll on African-Americans

by Will Boggs, MD

African-Americans have worse cardiovascular health and more deaths from heart disease than other groups, at least partly from less effective disease prevention and management efforts, according to a scientific statement from the American Heart Association (AHA).

“While African Americans are more likely to experience many cardiovascular diseases, in particular strokes and heart failure, they are also more likely to die from cardiovascular diseases,” Dr. Mercedes R. Carnethon from Northwestern University Preventive Medicine in Chicago told Reuters Health by email.

Because African Americans develop nearly all cardiovascular diseases - heart attack, stroke, and heart failure - at a relatively young age, she continued, “higher rates of death may arise from the length of time that African Americans live with these conditions.”

“Interrupting this process by preventing the early onset of cardiovascular diseases is one strategy to reduce disparities in cardiovascular disease mortality,” she said.

Traditional cardiovascular risk factors - high blood pressure, diabetes, obesity, and atherosclerosis - are more common and start at earlier ages among African Americans, Carnethon and colleagues report in the journal Circulation.

Unfortunately, not much has changed since 2005 when a special issue of Circulation pointed out disparities in the rates of cardiovascular disease, disease management, and outcomes for African-Americans.

Many of the differences arise from unhealthy behaviors, lower implementation of guidelines shown to improve cardiovascular health, ingrained cultural preferences and attitudes, and lack of persistence in following lifestyle changes that need to be lifelong, the research team writes.

African Americans also have higher rates of certain health conditions that predispose to cardiovascular disease - such as chronic kidney disease, sickle cell disease/sickle cell trait, and HIV, for example.

Genetic differences between African-Americans and other ethnic groups appear to explain only a small part of the disparity in cardiovascular disease rates and outcomes.

Finding strategies that reach younger African-Americans and men with disease prevention messages remains a significant challenge, Carnethon’s team notes.

“Cardiovascular diseases are preventable with healthy lifestyles,” she said. “Unfortunately, many African-Americans do not have equal access to the resources needed to lead healthy lifestyles, specifically access to healthy foods, safe spaces for physical activity, and peaceful homes and communities that promote restorative sleep.”

“Despite the strides our country has made in broadening access to healthcare, many African-Americans, particularly those in lower income groups, are still unable to afford and prioritize preventive care visits,” she said.

Dr. LaPrincess Brewer from the Mayo Clinic in Rochester, Minnesota, who has worked to promote cardiovascular health in African-American communities, told Reuters Health by email there’s a need for “culturally relevant, community-based cardiovascular health interventions that focus more on positive motivation towards promoting cardiovascular health rather than the negative impact of cardiovascular disease.”

“By increasing awareness of this enduring and colossal issue, we can then in turn empower African-Americans to play a role in improving their own cardiovascular health in tandem with their healthcare providers and social support networks,” she said.

“The AHA Life’s Simple 7 provides an evidence-based, advantageous framework to increase population-wide awareness among African-Americans,” she said.

Clinicians, researchers, public health practitioners, social services, and community stakeholders must work together “to develop an effective approach to improve cardiovascular health among all Americans,” Brewer said.

Brewer says "it will take a concerted effort to address not only the high burden of traditional risk factors among African-Americans, but also the plethora of social and environmental contextual barriers faced by this population.”

Black Chronic Stress and Heart Disease

by Kenny Anderson

Blacks are the most stressed population in the US and have been since slavery. Many studies show that just living under the constant stress of racism alone takes a tremendous health toll on so many Black people.

This constant stress is known as 'chronic stress' - the response to socioeconomic pressure suffered for a prolonged period of time that causes emotional distress, accelerated health decline, and the perception in which an individual perceives they have little or no control: 'a sense of powerlessness, defeatism, and fatalism'.

African Americans suffer more chronic stress which includes unending feelings of despair/hopelessness, anger, shame, worry, and grief; poverty, family dysfunctional stress, early childhood traumatic experiences, experienced and perceived racial discrimination, neighborhood stress, daily stress, acculturative stress, and environmental stress.

In her book, ‘Environmental Stress and African-Americans’, author Grace Carroll states that race is brought to the consciousness of African Americans every day through interaction with employers, service providers, landlords, the police, and the media.

Carrol says the stress experienced by Blacks merely as a result of being African American causes 'micro-aggressions' that include experiences such as being denied service, being falsely accused, being negatively singled out on account of one's race - 'Living While Black' (LWB).

Carroll labels the stress that results from such micro-aggressions as Mundane Extreme Environmental Stress (MEES) - which she says is a daily experience, has a significant impact on one's psychological well being and world view, is environmentally induced, and is detracting and energy consuming.

Arline Geronimus a professor of health behavior and health education at the University of Michigan echoes Carroll by stating the stress of living and working in a race conscious society slowly wears down Black people from all walks of life.

From Geronimus perspective racist stress, coupled with poverty, eventually erodes Blacks mental and physical health, a gradual process that she calls ‘weathering’. This daily weathering results in depression, substance abuse, suicide, strained relationships, and frustration that leads to misplaced Black-on-Black violence.

Stress and Heart Disease

Since African Americans suffer the most from chronic stress it should not be a surprise that we have the highest heart disease rate in the US. 

Our body’s response to stress is supposed to protect us, however if it is constant – chronic it harms us. The hormone cortisol is released in response to stress; studies suggest that the high levels of cortisol from long-term stress can increase blood cholesterol, triglycerides, and blood pressure. 

Chronic stress constantly raises the levels of cortisol creating inflammation that prevents cholesterol from freely moving throughout the body resulting in it accumulating in artery walls. 

Moreover chronic stress causes changes in immune cell genes, researchers found that chronic stress changes gene activity of immune cells before they enter the bloodstream so that they’re ready to fight infection or trauma - even when there is no infection or trauma to fight. This then leads to increased inflammation.

The changes in immune cell genes was seen in mice, as well as in blood samples from people with poor socioeconomic statuses (a predictor of chronic stress), reported the researchers from Ohio State University, the University of California, Los Angeles, Northwestern University and the University of British Columbia.

The University of California, Los Angeles (UCLA) researchers looked at blood samples from both the stressed mice, as well as humans who came from differing socioeconomic statuses. 

Just like in the mouse part of the experiment, 387 genes were identified that had differences in activity between the people who came from low socioeconomic backgrounds and those who came from high socioeconomic backgrounds. And just like in the mice, the up-regulated genes in those who came from low socioeconomic backgrounds were pro-inflammatory.

Even minor stress can trigger heart problems like poor blood flow to the heart muscle. This is a condition in which the heart doesn't get enough blood or oxygen. And, long-term stress can affect how the blood clots, this makes the blood stickier and increases the risk of stroke.

In a 2014 study conducted by a University of Pittsburgh researcher Dr. Peter Gianaros found that negative stressful emotions contributes to hardening of the arteries (atherosclerosis) by raising the levels of inflammatory causing chemicals in the body.

Recent research led by Dr Ahmed Tawakol of Harvard Medical School and Massachusetts General Hospital (2017), shows chronic stress can lead to the over-production of white blood cells, which can form plaques in the arteries and lead to heart disease.

Tawakol advocates that chronic stress should be treated as an important risk factor for cardiovascular disease like other major cardiovascular disease risk factors. 

African Americans with heart disease must start managing our stress just like we are told to manage the other major heart disease risk-factors: high blood-pressure, diabetes, and weight (obesity). 

Stress Management

As Blacks being up under so much pressure reducing stress in our everyday lives is vital for maintaining our overall health and quality of life; improving our mood, boosting our immune functioning, promoting longevity, and allowing us to be more productive. 

When we let constant stress get the best of us, we put ourselves at risk to finding relief in negative coping mechanisms 'addictions' of all types and developing a range of illnesses from the common cold to severe heart disease. 

The following are four healthy techniques that psychological research has shown to help reduce stress in the short and long-term:

Tip 1: Deep breathe - as soon as you become stressed breathe deeply because it lowers stress in your body by sending a message to your brain to calm down and relax.

Tip 2: Identify your stress - this will help identify how much stress you are under and ways to reduce stress in your life.

Tip 3: Be assertive - when you have too much unnecessary pressure demands coming at you from others just say no!

Tip 4: Take a break from the stress - when you step away from a stressful situation you let yourself have time to do something else 'debrief', which can help you have a new perspective or practice techniques to feel less overwhelmed.

Humming for Stress Relief

During the dark days of slavery our Ancestors particularly our foremothers hummed everyday for stress-relief 'soul-comfort'. 

12 instant benefits of humming (Carole Fogarty): 

1: Humming grounds and brings you back to your center; it helps settle the feeling of being restless or scattered on the inside.

2: Promotes clarity of thinking by refreshing your mind. You can physically feel the vibration of the “hum” clear out the cob webs.

3: Has a very relaxing and soothing effect on your neck, face, head and shoulder muscles, which helps dissolve stress. 

4: Humming reduces the number of thoughts that fill your head. When you are humming there is little room for over thinking.

5: Humming puts a smile on your face. 

6: Humming slows down your breathing rate significantly. Dr. Kataria’s research shows, we normally breathe 15-17 times in a minute but with humming you can bring it down to 4-6 a minute which helps to slow down your heart rate and brings down your stress level.

7: Helps dissolve unproductive thinking. If you are having a bout of negativity, jump straight into a few rounds of “hmmmm” and notice a shift in your thinking.

8: Calms your nervous system as it activates the parasympathetic nervous system.

9: Dr. Kataria firmly believes it helps those with insomnia or restless sleep patterns, and perfect for inducing a deep sleep without dreams (the best kind of sleep).

10: “Humming creates a wonderful circuit of energy in your body re-vitalizing its cells and charging its chakra’s” as quoted by Deva Premal

11: Improves sinusitis. The vibration helps shifts and clears pathways and blockages.

12: Lowers blood pressure as proven by Dr. Kataria. 5 minutes of humming can reduce your blood pressure between 10 – 20 mmHg. 

Black History Month: Daniel Hale Williams a Pioneering Black Heart Surgeon and Fighter to Improve Black Health Care

by Kenny Anderson

February is Black History Month and it's also National Heart Awareness Month, Doctor Daniel Hale Williams embodies both months focuses. Williams was a pioneering Black heart surgeon at a time when technological discoveries were revolutionizing the practice of medicine. 

In 1893, he became the first physician to successfully perform open heart surgery by entering the chest cavity of a young Black male stabbing victim James Cornish and repaired his heart sac; Cornish went on to live another fifty years after the surgery.

Williams was also responsible for early advancements in the accessibility of health care to urban Blacks in Chicago, opening Provident Hospital the first interracial hospital in the United States, in 1891. Provident not only improved health care for Black citizens, but also provided training and staff opportunities for young Black men and women interested in pursuing a vocation in the medical field. 

Doctor Daniel Hale Williams graduated from Northwestern University University Feinberg School of Medicine in 1883 and 135 years later according to the American Medical Association only 2.5 percent of all medical school applicants are African American males. In 1978, 1,410 Black men applied to medical school and 542 ended up enrolling. In 2014, both those numbers were down 1,337 applied and 515 enrolled. Every other minority group including Asians and Hispanics saw growth in applicants; there was also an uptick in applications by Black women.

I wonder if Doctor Williams thought when he performed the the first open heart surgery in 1893 that a 125 years later that African-Americans would lead the US in heart disease rates and their rates would be one of the highest in the world. 

According to 2013 data from the American Heart Association 48% of Black women 20 and older have heart disease, while 44% of Black men 20 and older have heart disease. Black women have a 31% death rate from heart disease while Black men have a 34% death rate. Before age 50 Blacks heart rate failure rate is 20 times higher than that of whites. Heart disease deaths kills more Blacks than all of the other 9 top ten killer diseases of Blacks combined. 

A study (2003 – 2007) at the University of Alabama at Birmingham shows Black men and women are more likely to die of a heart attack or heart failure than whites in the United States. Every year during the study, 4 in 1,000 Black men died from heart disease, on average, compared to 1.9 of 1,000 white men, the researchers found. Among women, 2 in 1,000 Blacks died of heart disease each year, compared to 1 in 1,000 whites.

Moreover I wonder if Doctor Williams would have thought that 125 years later that Blacks with heart disease would be discriminated against in getting open heart surgery a procedure he pioneered.

Research has shown Black heart attack patients are far less likely than whites to undergo common and potentially life-saving procedure known as cardiac catheterization. Blacks were less likely to have their surgery done under urgent, emergent, or salvage conditions, less likely their surgery done following an acute myocardial infarction.

A study that appeared in the March issue of Journal of the National Medical Association, researchers compared the rates of cardiac catheterization in about 585,000 white, 51,000 black, and 32,000 Hispanic people treated for heart attack in U.S. hospitals from 1995-2001. Researchers found cardiac catheterization rates were higher for whites than Blacks for all years examined, while rates among Hispanics approached that of whites during the study period.

The great Black historian John Henrik Clarke stated that: "History is a clock that people use to tell their political and cultural time of day. It is a compass they use to find themselves on the map of human geography. It tells them where they are, but more importantly what they must be."

Thus our historical clock tells us that our high rates of heart disease and racism in heart health care requires that we have to put in some internal (self-care) and external (advocacy) heart-based work! 

This Article on Heart Disease is Dedicated to the Memory of my Friend Ronald Collins

by Kenny Anderson

In early 2016 I was a 58 year-old Black man headed toward a certain quick heart attack death. I was suffering from coronary artery disease, having 4 completely blocked arteries – I had to have emergency open heart bypass surgery. 

Though I didn’t know I had this type of massive blockage in my blood vessels, it was not surprising because as a Black man I had been under stress my whole adult life. I personally believe based on living and research that 'stress is the major contributor' to why Black males have the highest death rates from heart disease in this country.

Prior to my surgery I did know that heart disease was prominent in my family history and that Blacks had the highest heart disease rate in the U.S. and one of the highest rates in the world. I've also known for some time about the 'stress impact of racism' on Black heart disease.  

During my post-surgery cardiac rehabilitation I made a commitment to take the lead in reducing the extremely high rates of African American heart disease, thus I started Black Hearts Matter. In the past year 10 Black males I knew died from heart disease mainly ‘heart attacks’ and 85% were under the age of 60.

Just the first week of this month another Black man I know Ronald Collins who was under age 60 died from heart disease  -  complications of congestive heart failure. Collin's was a solid good, down to earth 'tell it like it is Brother'; he was a math teacher and a football coach; he was a positive influential force in teaching, supporting, and guiding Black students, particularly young Black males.

Ronald Collins untimely death is hurtful but it further motivates me to carry on the work as a Black heart disease reduction advocate. For me the disproportionately high Black death rates from chronic diseases is the unfinished business of the Civil Rights struggle and the new battle front. Martin Luther King Jr. stated: "Of all the forms of inequality, injustice in health care is the most shocking and inhumane."

Some Blacks will say that God called Ron home; some will say it was just his time to go, I disagree with these fatalistic views. From my perspective, I believe that as Blacks we can prevent heart disease premature deaths through healthy lifestyle changes, heart awareness, and reducing heart disease risk factors: stress, hypertension, obesity, and the ignorance of heart attack and heart failure symptoms.

Indeed, African Americans are disproportionately affected by heart failure. A study in the New England Journal of Medicine noted that congestive heart failure is hitting African Americans in their 30's and 40's at the same rate as Whites in their 50's and 60's.

A 2013 study by the American Heart Association shows that African Americans are lagging significantly behind when it comes to knowing what the risk factors for heart disease thus making us more vulnerable to deaths from heart attacks and heart failure.

As Black folks we must understand that knowing the symptoms of heart failure and heart attacks can save our lives! 

Heart failure signs and symptoms may include:

*Shortness of breath when you exert yourself or when you lie down

*Fatigue and weakness

*Swelling (edema) in your legs, ankles and feet

*Rapid or irregular heartbeat

*Reduced ability to exercise

*Persistent cough or wheezing with white or pink blood-tinged phlegm

*Increased need to urinate at night

*Swelling of your abdomen

*Sudden weight gain from fluid retention

*Lack of appetite and nausea

*Difficulty concentrating or decreased alertness

*Sudden, severe shortness of breath and coughing up pink, foamy mucus

*Chest pain if your heart failure is caused by a heart attack


Heart Attack Symptoms

The symptoms of a heart attack can vary from person to person. Some people can have few symptoms and are surprised to learn they've had a heart attack. It is important that we know the most common symptoms of a heart attack and also remember these facts:

*Heart attacks can start slowly and cause only mild pain or discomfort. Symptoms can be mild or more intense and sudden. Symptoms also may come and go over several hours.

*People who have high blood sugar (diabetes) may have no symptoms or very mild ones. The most common symptom, in both men and women, is chest pain or discomfort.
*Women are somewhat more likely to have shortness of breath, nausea and vomiting, unusual tiredness (sometimes for days), and pain in the back, shoulders, and jaw.

Some people don't have symptoms at all. Heart attacks that occur without any symptoms or with very mild symptoms are called silent heart attacks.

The most common warning symptoms of a heart attack for both men and women are:

*Chest pain or discomfort. Most heart attacks involve discomfort in the center or left side of the chest. The discomfort usually lasts for more than a few minutes or goes away and comes back. It can feel like pressure, squeezing, fullness, or pain. It also can feel like heartburn or indigestion. The feeling can be mild or severe.

*Upper body discomfort. You may feel pain or discomfort in one or both arms, the back, shoulders, neck, jaw, or upper part of the stomach (above the belly button).

*Shortness of breath. This may be your only symptom, or it may occur before or along with chest pain or discomfort. It can occur when you are resting or doing a little bit of physical activity.

The symptoms of angina can be similar to the symptoms of a heart attack. Angina is chest pain that occurs in people who have coronary heart disease, usually when they're active. Angina pain usually lasts for only a few minutes and goes away with rest.

Chest pain or discomfort that doesn't go away or changes from its usual pattern (for example, occurs more often or while you're resting) can be a sign of a heart attack. All chest pain should be checked by a doctor.

Pay attention to these other possible symptoms of a heart attack:


*Breaking out in a cold sweat

*Feeling unusually tired for no reason, sometimes for days (especially if you are a woman)

*Nausea (feeling sick to the stomach) and vomiting

*Light-headedness or sudden dizziness

Any sudden, new symptoms or a change in the pattern of symptoms you already have (for example, if your symptoms become stronger or last longer than usual)

Not everyone having a heart attack has typical symptoms. If you've already had a heart attack, your symptoms may not be the same for another one. However, some people may have a pattern of symptoms that recur. The more signs and symptoms you have, the more likely it is that you're having a heart attack.

Quick Action Can Save Your Life: Call 9–1–1

The signs and symptoms of a heart attack can develop suddenly. However, they also can develop slowly - sometimes within hours, days, or weeks of a heart attack.

Any time you think you might be having heart attack symptoms or a heart attack, don't ignore it or feel embarrassed to call for help. Call 9–1–1 for emergency medical care, even if you are not sure whether you're having a heart attack.

Acting fast can save your life!

An ambulance is the best and safest way to get to the hospital. Emergency medical services (EMS) personnel can check how you are doing and start life-saving medicines and other treatments right away. People who arrive by ambulance often receive faster treatment at the hospital.

The 9–1–1 operator or EMS technician can give you advice. You might be told to crush or chew an aspirin if you're not allergic, unless there is a medical reason for you not to take one. Aspirin taken during a heart attack can limit the damage to your heart and save your life.

Every minute matters. Never delay calling 9–1–1 to take aspirin or do anything else you think might help.

To my Friend Ronald Collins 'Rest in Peace'

Congestive Heart Failure Striking African Americans at a Younger Age

by: Shantella Y. Sherman

Congestive heart failure remains one of the most taxing, but preventable, heart conditions in the U.S. and is increasingly linked to heart disease caused by poor diet.

Consequently, African Americans are disproportionately affected by heart failure and the disparity has been attributed in many cases to modifiable risk factors such as uncontrolled hypertension and inadequate health care.

While previous medical trends target middle-aged Black populations in awareness efforts, increasingly diagnosis of heart failure is occurring earlier among African Americans.

In fact, a 2009 study in the New England Journal of Medicine noted that congestive heart failure is hitting African Americans in their 30s and 40s at the same rate as Caucasians in their 50s and 60s.


“These findings illustrate the importance of identifying solutions to the social, economic, environmental, and health care-related factors that contribute to persistent health disparities,” said Risa Lavizzo-Mourey, president and CEO of the Robert Wood Johnson Foundation. 

“The study results also highlight the urgency of reversing the childhood obesity epidemic. Today’s unhealthy children are tomorrow’s unhealthy adults. 

We know that obese children are being diagnosed with conditions previously considered adult illnesses, such as Type 2 diabetes and hypertension, and they’re at higher lifetime risk for a host of serious health problems, including heart disease, stroke, diabetes, asthma and some forms of cancer.”

Contrary to popular belief, heart failure does not mean that the heart suddenly stops. The heart functions as a blood pump that moves blood from the right side of the heart to the lungs to pick up oxygen. 

The oxygenated blood returns to the left side of the heart. The left side of the heart then pumps blood into the circulatory system of blood vessels that carry blood throughout the body. 

When the pumping action is compromised, so too is blood and oxygen flow to the rest of the body, causing congestive heart failure patients to experience swollen feet and legs, kidney malfunction, and pleurisy (fluid in the lungs). 

Among African Americans, hypertension remains the overwhelming sole predisposing factor to developing congestive heart failure.

The Centers for Disease Control and Prevention acknowledged in the 2012 report Preventable Hospitalizations for Congestive Heart Failure: Establishing a Baseline to Monitor Trends and Disparities that an alarming linear increase in CHF hospitalization was occurring among young Black men between the ages of 18-44. 

Chief among young African Americans, diet – particularly those high in salt, fat, sugar, and processed foods – contributes overwhelmingly to developing chronic conditions including hypertension and chronic kidney disease that portend congestive heart failure.

Despite the fact that young adults are often unaware that they have hypertension or the consequential link of the condition to heart failure when left untreated, ignoring the signs could lead to a pandemic of premature, preventable deaths.

While stressing the need for awareness across age demographics, the Robert Wood Johnson Foundation researchers suggest promoting proper diet – avoid fast food, processed foods, plenty of whole grains, fruits and veggies, and daily exercise – to ward off chronic conditions.

“There should be a wake-up call on the need for African Americans and physicians to address risk factors that can lead to heart failure. Heart failure is disproportionately hitting African Americans in the prime of their lives,” said Kirsten Bibbins-Domingo, lead author of the study.