Mayo Clinic Q and A: African Americans and heart health

DEAR MAYO CLINIC: I am an African American woman in her 40s. I recently had a well-woman checkup done and was told that I also should have a cardiac workup. Although I don’t eat as healthy as I should and high blood pressure and cholesterol run in my family, I have not begun menopause yet. Why do I need to be concerned about heart disease now?

ANSWER: Heart disease is the No. 1 cause of death in women in the U.S. Many African American women are not aware of that fact or that African American women have an even higher risk of dying from heart disease — and at a younger age — than white women, according to the National Heart, Lung and Blood Institute.

Each year, more African American women die from heart disease than breast cancer, lung cancer and strokes combined. But many do not realize the factors that increase their risk of developing heart disease or that they are at increased risk.

African American women face a high burden of negative social determinants of health. Although it may not apply to you specifically, it is valuable to help bring awareness of how issues such as chronic stress related to food insecurity, racism, the wealth gap and socioeconomically disenfranchised communities can prevent some people from living a healthy lifestyle and controlling many heart disease risk factors.

There is an increased awareness in trying to change the narrative on heart health and African American women. It is commendable that your health care professional proactively noted your risk, regardless of whether you are dealing with any of these specific health disparities.

I recommend that all women follow heart disease prevention strategies and consider the American Heart Association’s Life’s Essential 8 to achieve ideal heart health:

1. Manage blood pressure.
   Statistics tell us that African Americans have the highest hypertension rates in the world. Untreated, high blood pressure increases the risk of heart attack, stroke and other serious health problems. Given your family history, it is important to have your blood pressure checked regularly.
2. Control cholesterol.
   While national guidelines for women, in general, recommend screenings for cholesterol at age 45, if you have a known risk for coronary artery disease, screening earlier is appropriate. This can guide any additional tests that may be needed to check for specific areas of concern related to the heart’s function.
3. Reduce blood sugar.
   Diabetes is a significant heart disease risk factor for African Americans. At least annually, your blood glucose level should be checked. If you do have diabetes, be proactive with your management.
4. Get active.
   African American women are the least physically active group of women in the U.S. Embrace being physically active if you can. Guidelines recommend 150 minutes of vigorous activity a week, which can be challenging for many women. You can start small. Just keep moving.
5. Eat better.
   Familiarize yourself with the Mediterranean diet. It was noted that heart disease is not as common in Mediterranean countries as it is in the U.S. Numerous studies have confirmed that the Mediterranean diet helps prevent heart disease and stroke. Plant-based foods, such as whole grains, vegetables, legumes, fruits, nuts, seeds, herbs and spices, are the foundation of the diet. Olive oil is the main source of added fat. Fish, seafood, dairy and poultry are included in moderation. Red meat and sweets are eaten only occasionally.
6. Lose weight.
   Obesity can affect the heart’s ability to pump effectively. Take measures to lose and manage weight to reduce the risk for cardiac conditions.
7. Stop smoking.
   One of the best things you can do for your heart is to stop smoking or using smokeless tobacco. Even if you’re not a smoker, be sure to avoid secondhand smoke. Chemicals in tobacco can damage the heart and blood vessels. Cigarette smoke reduces the oxygen in the blood, which increases blood pressure and heart rate because the heart has to work harder to supply enough oxygen to the body and brain.
8. Get healthy sleep.
   Insomnia and sleep apnea are linked to high blood pressure and heart disease, and also can increase the risk of stroke. Lack of sleep also can affect weight. For people with diabetes, good sleep habits can help improve blood sugar.

Personally, I always recommend that African American women be diligent in protecting their hearts, and that also includes taking time for themselves. Self-care really does matter, and that includes scheduling a heart health checkup at an earlier age. Make heart health a priority now. — Dr. LaPrincess Brewer, Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota

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