Heart Failure :: Blacks’ higher risk for heart failure with diabetes, hypertension

Diabetes and high blood pressure, two conditions rooted in genetics and environmental surroundings, play a much greater role than race alone in determining who is mostly likely to develop heart failure, according to the latest study from cardiologists at Johns Hopkins. Each year, nearly 300,000 Americans die from heart failure.

Experts say that racial disparities have long been known to exist in who actually develops risk factors for the condition, with African Americans nearly twice as likely to be diagnosed with diabetes and more than a third as likely to have high blood pressure than Caucasian Americans.

But researchers have only now determined the precise role played by race in comparison to other risk factors, including socio-economic factors, age, gender, smoking, family history, and other health problems, as well as diabetes and hypertension.

The Hopkins team will present its findings March 27 in New Orleans at the American College of Cardiology?s annual Scientific Sessions in New Orleans.

In the study, researchers monitored nearly 7,000 men and women, age 45 to 84, of different ethnic backgrounds and with no existing symptoms of heart disease. African Americans developed heart failure at significantly higher rates (4.6 cases per 1,000 per year) than all other races, including Hispanics and Caucasians. Their rate was almost five times that of Chinese Americans (1 case per 1,000 per year) and almost twice that of Caucasians (2.4 cases per 1,000 per year).

However, these apparent risk differences among races almost disappeared (dropping from twice as likely, a significant difference, to no more than one-and-a-half times as likely, an insignificant difference) when researchers used statistical techniques to exclude the two traditional risk factors for heart disease.

?When all major factors are taken into account, the differences between races for heart failure largely evaporate in the absence of diabetes and hypertension among African Americans,? says senior study investigator Jo?o Lima, M.D.

According to Lima, an associate professor of medicine and radiology at The Johns Hopkins University School of Medicine and its Heart Institute, these early results add to other interesting findings from the so-called Multiethnic Study of Atherosclerosis (MESA).


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