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Heart disease in African Americans: Why it is more common and what you can do to prevent it
General Wellness

Heart disease in African Americans: Why it is more common and what you can do to prevent it

By Oluwaseun Akinseye MD, Cardiology, Interventional Cardiology
Posted: February 22, 2021

Heart diseases, such has coronary heart disease and heart failure, are more common in African Americans than other ethnic groups — and so are the other cardiovascular diseases such as stroke and peripheral artery disease. The reason for this is multifactorial.

The risk factors for heart diseases, such as hypertension, diabetes mellitus, obesity and sleep disorders, are more common in African Americans even at a young age. Other social and economic factors are more common among African Americans as well. They include:

  • Cost barriers to quality health care
  • Higher uninsured rate, low level of education
  • Higher poverty rate
  • Poor diet quality
  • Availability of nutritious and healthful food in the neighborhood
  • Low adherence to recommended physical activity due to working two or more low paying jobs with no time for exercise
  • Neighborhood walkability

These social and economic factors, along with other environmental determinants of health, can negatively impact a person’s well-being, and lead to conditions like heart disease.

Are African Americans at a higher risk for heart disease?

African Americans are at a higher risk for heart disease than other ethnic groups.

Nearly 48% of African American women and 44% of African American men have some form of heart disease. The rate of heart disease is also higher in the growing middle and upper-class African American community than in white Americans with comparable socioeconomic status.

What are the risk factors for heart disease?

The risk factors for heart disease include hypertension, diabetes mellitus, high cholesterol level, obesity, sleep apnea and sleep disorders and cigarette smoking.

These risk factors are unfortunately more common in African Americans than other race/ethnic groups, even at a younger age, therefore causing silent organ damage and heart disease even before they are sometimes diagnosed.

Other risk factors that have directly and indirectly contributed to the higher burden of heart disease among African Americans include cost barriers to quality health care, higher uninsured rate, low level of education, higher poverty rate, poor diet quality, low level of exercise, and other environmental barriers to physical activity.

For example, neighborhoods with lower-income or high proportions of race/ethnic minorities are likely to lack public and commercial facilities for physical activity, walkability and safe green space, increasing sedentary lifestyle and physical inactivity, which is a known risk for heart disease.

These neighborhoods also have fewer supermarkets or specialty food stores, resulting in limited availability of fresh and healthy foods. Even when present, these foods are more expensive compared to traditional foods that are higher in fat, calorie and sodium content.

These contents are known to worsen the burden and subsequent optimal control of risk factors like hypertension, diabetes mellitus, kidney disease and obesity, worsening the epidemic of heart disease.

The cumulative effects of all these factors can be harmful to the cardiovascular health of African Americans and other race/ethnic minorities.

The statistics tell a compelling story

While the national death rate for heart disease has gradually declined for all ethnic groups over the years, rates for African Americans remained 20% higher compared to rates in white Americans (1).

Studies have shown that over a quarter (28%) of all heart disease deaths among African Americans occurred in those aged 65 years and younger, compared with 13% among white Americans of similar age.

According to Center for Disease Control and Prevention, African Americans aged 18-49 are two times as likely to die from heart disease than whites.

Other studies have suggested there is a possibility of unaccounted factors outside of clinical and socioeconomic factors that may explain the higher cardiovascular disease rate, especially among young to middle-aged African Americans. Over a quarter (28%) of all cardiovascular deaths among African Americans occurred in those age 65 or younger, compared with 13% among whites, according to analyzed data from the National Health and Nutrition Examination Survey data from 1999-2006 (2).

Increased focus on young and middle-aged African Americans may help narrow the black/white disparity in cardiovascular deaths.


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What can you do to lower your risk of heart disease?

The first recommendation is to know your numbers and get regular health checkups.

Get Screened and Be Informed

The United States Preventive Services Task Force recommends screening for high blood pressure in those 18 years and older. It is recommended to screen for abnormal blood glucose as part of cardiovascular risk assessment in adults age 40 to 70, and there’s increased advocacy to screen for abnormal blood glucose at an earlier age in African Americans.

It is important to work with your provider to keep blood pressure, blood glucose and cholesterol levels under control. For individuals with health insurance, there are ongoing community partnerships with nongovernmental organizations and faith-based communities offering cardiovascular risk screening and providing necessary information to reduce the risk of heart disease, along with referrals to community resources for those diagnosed with heart disease risk factors.

Take Prescribed Medications and Communicate With Your Provider

It is important to take medications for high blood pressure, diabetes and heart disease as instructed by your doctor. If you have side effects from your medications, inform your provider so they can go over different ways to reduce the side effect or change the medication, rather than stopping altogether on your own, which increases the risk of morbidity and mortality from heart disease.

Monitor Unusual Leg Pain

Experiencing pain in the leg while walking, that improves with rest, may signify peripheral artery disease and should be checked with your doctor early as it may be a pointer to higher risk of heart disease.

Stay Active

Current physical activity recommendations state that adults should engage in 150 minutes per week of moderate-intensity aerobic physical activity — or 75 minutes per week of vigorous-intensity aerobic physical activity — to reduce the risk of heart disease and death.

Staying physically active reduces weight, may reverse early diabetes and high cholesterol level, and helps improve hypertension control.

Walking 10 minutes, three times a day, for at least five days per week will give a total of 150 minutes of moderate-intensity activity. For individuals without neighborhood parks or space for exercise, daily exercise at home or at work may include going up and down a flight of stairs or walking in circles while lifting the knees as high as possible. This can increase the metabolic demand of the heart.

Healthy Weight and Balanced Diet

Maintain a healthy weight. A big belly compared to your hip size signifies being overweight and is associated with adverse risk for heart disease.

Eating a healthy diet is important in reducing the risk of heart disease and its risk factors. The American Heart Association and American College of Cardiology recommends a diet that emphasizes fruits, vegetables and whole grains, including low-fat dairy products, poultry, fish, legumes, non-tropical vegetable oils and nuts.

It is advised to limit intake of sweets, sugar-sweetened beverages and red meats.

Limit the use of deep frying and other cooking techniques common with traditional soul food that add excess calories and sodium.

Individuals with hypertension, heart failure, chronic kidney disease and diabetes should limit salt intake to 1500mg of sodium per day (two to three teaspoons of salt). If thirsty, drink water instead of juice or soda.

Other Steps You Can Take

Avoid or cut down on smoking.

Ensure you are getting good quality sleep, six to eight hours per day. Not too short, not too long.

Manage your stress level, and spend and enjoy time with loved ones.

Still Have Questions About Your Heart Health?

Schedule an appointment with one of our cardiologists.

In This Article:
  1. Mensah, George A. "Cardiovascular diseases in African Americans: fostering community partnerships to stem the tide." American Journal of Kidney Diseases5 (2018): S37-S42.
  2. Jolly, Stacey, et al. "Higher cardiovascular disease prevalence and mortality among younger blacks compared to whites." The American journal of medicine9 (2010): 811-818.

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