Most people are terrified of having a heart attack, but they might also need to worry about heart failure, particularly if they are black.
After years of decline and despite treatment advances, the risk of dying early from heart failure-related causes started increasing after 2012, new research shows. Black men seem especially hard hit by this troubling new trend, the study authors noted. “These findings are really important for two reasons. The overall rise from 2012 is a consequence we’ve seen from the rising obesity and diabetes epidemics,” said senior study author Dr. Sadiya Khan. She’s an assistant professor in the department of medicine and preventive medicine in the division of cardiology at Northwestern University Feinberg School of Medicine in Chicago.
“The second reason is the rise in premature deaths of people under 65, especially among black men. This heart failure trend is another manifestation of the undertreatment of hypertension [high blood pressure],” she said. Heart failure occurs when the heart has trouble keeping up with the demands placed on it. A variety of conditions can weaken the heart and make it less able to do its job, but two major causes of heart failure are heart disease (plaque buildup in blood vessels) and high blood pressure, the American Heart Association (AHA) says.
According to Dr. Ileana Pina, an AHA spokesperson, “The heart is working very hard against ‘pipes’ that are tight, and the heart eventually can’t take that pressure. The extra work sometimes causes the heart to thicken and dilate [or enlarge], and sometimes the heart just dilates.” Heart failure is a chronic and progressive disease, Khan said. It can cause death in a number of ways, but about half of heart failure deaths are from cardiovascular causes, such as the heart suddenly stopping, a heart attack or a stroke.
Approximately 6 million Americans suffer heart failure, the study authors noted.
The study tracked heart-failure related deaths from 1999 through 2017 in the United States. In 1999, there were nearly 79 cardiovascular disease deaths from heart failure per 100,000 people. By 2012, that number was down to 54 deaths. In 2017, the number had jumped back up, and was 59 deaths from heart failure per every 100,000 people.
In 1999, black men had a 16% higher rate of deaths from heart failure compared to white men. By 2017, that rate was 43% higher. The rates in black women were 35% and 54% higher in the same time periods, respectively. The differences were more significant in younger black people (35 to 64 years). When the researchers controlled the data based on age, they found that black people had a nearly tripled higher risk of dying due to heart failure.
Khan said prevention is crucial. “Once heart failure develops, mortality is still 50% at five years,” she said.
The most important step in prevention is controlling blood pressure.
“Know your blood pressure and make sure it’s being well managed and well-treated,” she said. Khan added that maintaining a healthy weight, getting screened for diabetes, and quitting smoking are also important factors in preventing heart failure. Pina said she wasn’t surprised by the findings, and she agreed with Khan that patients need to get their blood pressure checked and treated if it’s high. “Hypertension is still a problem, in spite of the fact that we have wonderful drugs that work and are cheap. But patients don’t feel hypertension. That’s why it’s called the silent killer,” Pina said.
The findings were published May 6 in the Journal of the American College of Cardiology.
Learn more about heart failure from the American Heart Association.By Serena Gordon