Heart Disease Outcomes and Race Play?


PITTSBURGH, Pa. (Ivanhoe Newswire)— As many as one in 500 American adults have cardiomyopathy, meaning their hearts have become enlarged, thickened, or rigid, making it difficult for the heart to pump blood through the body. Now, new research examines racial disparities in the outcomes of these heart patients. Heart disease outcomes

People with cardiomyopathy may have no symptoms at all or their symptoms may be very mild at first.

“Over time, if we don’t get patients on good medications and things like that, then they will progress to what we call clinical heart failure, where they develop symptoms of shortness of breath, leg swelling,” Shazli Khan, MD, an internal medicine specialist at the University of Pittsburgh Medical Center, told Ivanhoe.

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Dr. Khan is studying racial disparities in cardiomyopathy outcomes. She and her colleagues looked at data from 18,000 patients over a six-year period.

Dr. Khan detailed, “What we actually found was that black patients in our cohort had a much higher prevalence of a lot of chronic medical conditions. So more chronic kidney disease, higher blood pressure, higher rates of diabetes.  In fact, they were actually dying more than the white patients with cardiomyopathy.”

Researchers found black patients diagnosed with cardiomyopathy were 15 percent more likely to die than white patients. Dr. Khan says the study findings suggest that providers should stress earlier interventions.

“That they’re coming in to fill their medications, making appointments, giving them resources and sort of educating them on what the long-term effects of certain conditions are,” Dr. Khan noted.

Dr. Khan says cardiomyopathy symptoms may be mild or vague at first, so having this information about comorbidities and race could help physicians identify higher risk patients earlier.

Contributors to this news report include: Cyndy McGrath, Producer; Kirk Manson, Videographer; Roque Correa, Editor.

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REPORT:       MB #4941

BACKGROUND: Cardiomyopathy is a disease of the heart muscle, and it isn’t a single condition, but a group of conditions called the cardiomyopathies. It affects the muscle of the heart, and can impact its shape, or the size and thickness of the muscle walls. This reduces the heart’s ability to pump blood around the body. This means that the heart structure and how it works are affected.  This type of disease can affect people of all ages, and can be genetic, or run in families.

(Source: https://www.cardiomyopathy.org/campaigns/background-information-on-cardiomyopathy)

DIAGNOSING: Doctors will perform a physical examination and ask questions about your personal and family medical history. You’ll also be asked when your symptoms occur, for example, whether exercise brings on your symptoms. If your doctor thinks you have cardiomyopathy, several tests may be done to confirm the diagnosis, including an X-ray test to see if your heart will show whether it’s enlarged, Several blood tests might be done, including those to check your kidney, thyroid and liver function and to measure your iron levels and a treadmill test to see your heart rhythm, blood pressure and breathing while you walk on a treadmill. Your doctor might recommend this test to evaluate symptoms, determine your exercise capacity and determine if exercise triggers abnormal heart rhythm.

(Source: https://www.mayoclinic.org/diseases-conditions/cardiomyopathy/diagnosis-treatment/drc-20370714)

NEW RESEARCH: Currently, we know that when Black patients are optimized on heart failure therapy and continue to have symptoms, they may receive additional benefit by taking hydralazine and isosorbide dinitrate, known by the brand name BiDil. Patients are advised to focus on eating more fruits and vegetables, whole grains and lean proteins, such as chicken or fish.  Finally, focus on maintaining a healthy body weight by balancing calorie intake with physical activity to reduce the risk of developing heart disease. Previous research suggested Black patients had a much higher prevalence of chronic medical conditions, including chronic kidney disease, higher blood pressure, and higher rates of diabetes. In fact, they were actually dying more than the white patients with cardiomyopathy.

(Source: https://www.uchicagomedicine.org/forefront/heart-and-vascular-articles/heart-disease-and-racial-disparities)





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Doctor Q and A

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