Black American women have higher rates of many risk factors for heart disease, including obesity, physical inactivity, metabolic syndrome, diabetes, and hypertension than white women

1. A Healthier Community
Education and knowledge can help save your life
Presented be Jacob Mason, RCIS

2. Disclosure
There are no relationships between planners or faculty of this program with
pharmaceutical companies, biomedical device manufacturers and/or
corporations whose products or services are discussed today.

3. The Issue

4. What is the issue?

Heart disease causes more deaths in Americans of both sexes and all racial and ethnic groups than
any other condition
Every 38 seconds, an American dies of heart disease1
 Despite similar prevalence across racial/ethnic groups, women and people of color are treated at a
lesser rate for heart disease than Caucasian men
 Even when they have insurance and are of the same social class, minorities often receive a lower
quality of care than do their white counterparts
1. American Heart Association. Heart Disease and Stroke Statistics – 2010 Update. Circulation. 2009;119:e21-e181.

5. Magnitude of SCA in the US
163,000
Stroke1
Lung Cancer2
152,200
Breast Cancer2
AIDS3
40,000
18,000
Heart Association. Heart Disease and Stroke Statistics –2008 Update.
A. CA Cancer J Clin. 2003;53:5-26.
3 U.S. HIV & AIDS Statistic Summary. Avert.org.
1 American
2 Jemel
SCA claims
more lives
each year
than these
other causes
of mortality.
400,000
SCA10
#1 Killer in
the US

6. Reasons for Disparities are Complex

Patient Related
– Patient preferences
– Treatment refusal
– Care seeking behaviors and attitudes
– Clinical appropriateness of care

Health Care System Related
– Geographic availability of health care institutions
– Changes in the financing (health insurance access) and delivery of
health care services
– Lack of interpretation and translation services
– Time pressures on physicians

Provider Related
– Bias
– Clinical uncertainty
– Beliefs/stereotypes about the behavior or health of minority
patients
Source: Henry J. Kaiser Family Foundation . Why the Difference Power Point Presentation, slide # 26. Unequal Treatment:
Confronting Racial and Ethnic Disparities in Healthcare, March 2000. Available at http://www.kff.org/whythedifference/speakerkit.htm
Accessed Sept.15, 2008

7. Risk Factors
•
•
•
•
•
•
•
•
•
Family History
Age
Tobacco/Smoking
Diabetes
High Blood Pressure
High/Unhealthy Cholesterol Levels
Obesity
Physical Inactivity
Unhealthy Diet

8. Why Focus on Disparities in Cardiovascular Health Care?
 Cardiovascular disease (CVD) is the #1 killer of American women, blacks and Latinos1
 By the year 2050, people from minority populations are expected to represent nearly
50% of the U.S. population2
 Even when they have insurance and are of the same social class, minorities often
receive a lower quality of care than do their white counterparts2
 While some progress has been made in primary care, recent studies suggest that little
progress has been made in addressing racial & ethnic disparities in cardiovascular
care2

9. In the United States,
 42.1 million women (36%)2 are living with cardiovascular disease (CVD)
and the
population at risk is even larger1
 Black American women have higher rates of many risk factors for
heart disease, including obesity, physical inactivity, metabolic
syndrome, diabetes, and hypertension than white women2
 Latino women are more likely to be diabetic, physically inactive,
overweight, and obese compared to white women3
One-third of women fail
to recognize their own
risk for heart disease4
1 Mosca, L et al. Evidenced-Based Guidelines for Cardiovascular Disease Prevention in Women: 2007 Update Circulation: 2007 115:14811501
2 Mosca, L et. al. Evidence-based Guidelines for Cardiovascular Disease Prevention in Women. Circulation. 2004. 109-672-693.
3 Christian, A. et al. Nine-Year Trends and Racial and Ethnic Disparities in Women’s Awareness of Heart Disease and Stroke: An
American Heart Association Study. Journal of Women’s Health. Volume 16, Number 1. 2007
4 National Heart, Lung, and Blood Institute (NHLBI). The Heart Truth from Dr. Elizabeth Nabel. Available at
http://www.nhlbi.nih.gov/health/hearttruth/press/riskfactor_nabel.pdf. Accessed Oct. 15, 2008.

10. Possible Signs and Symptoms In Women

11. Possible Signs and Symptoms In Men

12. Black Americans and Heart Failure

Black Americans are more likely to have heart failure and
suffer more severely from it1

Black Americans are also more likely than other groups
to:1
• develop symptoms at an earlier age
• have their heart failure get worse faster
• have more hospital visits
• die from heart failure
Black Americans are more
likely to have high blood
pressure than any other
ethnic group3
1 National Heart Lung & Blood Institute: Heart Failure: Who is at Risk? Available at
http://www.nhlbi.nih.gov/health/dci/Diseases/Hf/HF_Who IsAtRisk. Accessed Sept. 25, 2008
2 National Minority Quality Forum. Heart Failure in African Americans. Available at http://www.nmhm.org/aaheart Accessed Sept. 25, 2008
3 National High Blood Pressure Education Program, NHLBI Downloadable resource “Prevent and Control High Blood Pressure: Mission Possible What Every African
American should Know. Available at http://www.nhlbi.nih.gov/health. Accessed Sept. 25, 2008.

13. Black Americans between the ages of 45 and 64 are
2.5 times more likely to die from heart failure than
Caucasians in the same age range2
Heart failure

14. Black Americans & High Blood Pressure (Hypertension)
 Black Americans are more likely to have high blood pressure than any
other ethnic group1
 For black Americans, high blood pressure tends to be more common and
more severe
• is a major reason why black Americans die at an earlier age
• is a major reason why black Americans are 8 times more likely to
develop kidney failure than whites

15. Coronary Anatomy
Front of the heart
Back of the heart

16. Coronary Artery Disease
Foam
cells
Fatty
streak
Evolution of the Atherosclerotic Plaque: a Closer Look
Intermediate Atheroma Fibrous
lesion
plaque
Complicated
lesion/rupture
Endothelial dysfunction
From first decade
From third decade
From fourth decade
Plaque rupture

17. Reasons for Cardiac Cath
• Patient Symptoms
• Chest Pain
• Shortness of Breath
• Fatigue
• Abnormal 12 Lead ECG
• STEMI
• NSTEMI
• Physical and History
• Murmur
• Diabetes
• Hyperlipidemia
• Smoker
• Family History
• Known CAD
• Positive Stress Test
• Pharmacologic
• Treadmill test
• Nuclear Scan
• Stress-Echocardiogram

18. Exercise for a Healthy Heart
A sedentary (inactive) lifestyle is one of the top risk factors for heart disease. Fortunately, it's a risk factor
that you can do something about. Regular exercise, especially aerobic exercise, has many benefits. It
can:
• Strengthen your heart and cardiovascular system
• Improve your circulation and help your body use oxygen better
• Improve your heart failure symptoms
• Increase energy levels so you can do more activities without becoming tired or short of breath
• Increase endurance
• Lower blood pressure
• Improve muscle tone and strength
• Help reduce body fat and help you reach a healthy weight
• Help reduce stress, tension, anxiety, and depression
• Boost self-image and self-esteem
•Make you feel more relaxed and rested
• Make you look fit and feel healthy

19. Exercise for a Healthy Heart
A sedentary (inactive) lifestyle is one of the top risk factors for heart disease. Fortunately, it's a risk factor
that you can do something about. Regular exercise, especially aerobic exercise, has many benefits. It
can:
• Strengthen your heart and cardiovascular system
• Improve your circulation and help your body use oxygen better
• Improve your heart failure symptoms
• Increase energy levels so you can do more activities without becoming tired or short of breath
• Increase endurance
• Lower blood pressure
• Improve muscle tone and strength
• Help reduce body fat and help you reach a healthy weight
• Help reduce stress, tension, anxiety, and depression
• Boost self-image and self-esteem
•Make you feel more relaxed and rested
• Make you look fit and feel healthy

20. Mediterranean diet
The Mediterranean diet is one of the most popular
diets in the health and fitness field. There has been
much research on on the whole diet, how it works
and why it works.

21. Thank you!