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Cardiovascular Disease in the African American Community - Causes, Preventions, and Treatments

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Cardiovascular Disease in the African American Community

Causes, Preventions, and Treatments

Cardiovascular disease (CVD) refers to the dysfunctional conditions of the heart, arteries, and veins that supply oxygen to vital life- sustaining areas of the body like the brain, the heart itself and other vital organs. Since the term cardiovascular disease refers to any dysfunction of the cardiovascular system there are many different diseases in the cardiovascular category, and many of these diseases are strongly intertwined. Ischemic Heart Disease is the medical idiom for the obstruction of blood flow to the heart. It is usually due largely in part to excess fat or plaque deposits that narrow the veins that provide oxygenated blood to the heart. This excess fat buildup and plaque are respectively known as arteriosclerosis and atherosclerosis. Hypertension is frequently a result of both arteriosclerosis and atherosclerosis, and can lead to more serious CVDs, such as angina attack (an acute and squeezing chest pain due to inefficient blood flow to the heart), and myocardial infarction( the sudden death of part of the heart muscle). A stroke is a CVD that occurs when there is in inadequate oxygen flow to the brain. An abnormally high or abnormally low heart rate because of the disruption of the natural electric impulses of the heart is called cardiac arrhythmia. Carditis and endocarditis, the infection and inflammation of the heart, can occur as a result of a weak immune system, liver problems, heart surgery, or an autoimmune disorder.

A number of health -related behaviors contribute remarkably to the onset cardiovascular disease. Smokers are two times as likely to have a heart attack as non-smokers, and one fifth of the annual 1,000,000 deaths from CVD can be attributed to smoking. A sedentary lifestyle increases one's risk of heart disease. However, America remains predominantly sedentary, and more than half of American adults do not practice the recommended level of physical activity, while more than one-fourth are completely sedentary Between 20-30%, approximately 58 million people, of the nation's adults are obese. Obesity severely increases risk for hypertension, high cholesterol, and other chronic diseases which have been proven to cause heart disease. As one can clearly see cardiovascular disease is a very broad topic encompassed by many different malfunctions and causes.

The all encompassing nature of cardiovascular disease in no way takes away from the severity of it. In fact, CVD is the leading cause of death in the United States. In the US one person dies every 30 seconds from heart disease, that's over 2,600 people every day. As serious a problem as heart disease is to the general population, cardiovascular disease is ravaging the African American community. In 2001 alone, 48,939 black males and 56,821 black females died of heart disease. Clearly heart disease is more than just a problem in the African American community; it is a matter of life or death. Which raises the question, why do African Americans have such a higher propensity for heart disease? Naturally, there is a multi-faceted answer. African Americans have a higher occurrence of the health related behaviors that lead to heart disease, are biologically more apt to develop risk factors related to heart disease, and have a greater likelihood to be apart of a social network with an increased incidence of CVD.

A large number of biological variables are thought to be related to the greater prevalence of heart disease in African Americans. These variables include a greater degree of sensitivity to dietary sodium, increased cardiovascular reactivity, increased vascular resistance, and increased prevalence of LVH, hyperinsulinemia, and lower rennin or prostaglandin levels. Most importantly however, is the predisposition to hypertension and dyslipidemia. Hypertension is described as blood pressure values above 120/80 mm hg, and often results from excess fat or plaque build up because of the extra effort it takes to circulate blood. These blockages shortchange many of the areas of the body of blood supply, even though the heart is working at an increased rate to circulate. The body is often able to mask the subtle damage due to the extra work the cardiovascular system is undergoing, but not forever, and for that reason hypertension is often referred to as "the silent killer". In fact, approximately 27% of African Americans with hypertension are unaware of their condition. Unfortunately, many times the first warning signs of hypertension are angina attack, stroke, or even myocardial infarction, all severe cardiovascular diseases. Dyslipidemia is defined as a total cholesterol level greater than 200 mg/dl., LDL cholesterol above 130 mg/d, HDL cholesterol bellows 35 mg/dl; and a lipoprotein level greater than 30 mg/dl. An elevated cholesterol level rigorously lends itself towards conditions such as atherosclerosis, which can in turn lead to more serious CVDs. However, cholesterol is not actually a damage mechanism but rather a risk factor for increased risk of heart disease.

In many aspects of health and disease, biological and genetic variables are considered to be the most important in reaching a medical solution to a problem. Nevertheless, evidence suggests that social disparities between African Americans and the rest of the American population may have a greater influence over disease prevalence then genetic differences. It is common knowledge, that as a race African Americans are far more likely to live and remain living below the poverty line. For this reason, the African American community does not always enjoy the healthcare benefits that an increased socio-economic status would bring. Therefore, access to healthcare and healthcare information is not a constant option. For example, 32% of African Americans with hypertension are receiving inadequate treatment. Lower levels of education, employment status, and income are also socio-economic risk factors towards CVDs, , which lead to unnerving statistics such as the 17% of African Americans with hypertension that are aware of their condition, but are not being treated for it. Being overweight, leading a sedentary lifestyle, and smoking are the most commonly cited modifiable risk factors that contribute to an increased prevalence in heart disease. All of which are behaviors commonly exercised within the Black community. Additionally, patterns of diets and exercise are behavioral risk factors that augment the incidence of heart disease in the African American population as a result of their culture. Because of the lower socio-economic status, African Americans are not commonly awarded the luxury of eating the healthiest food or taking the time out to exercise. Also, culturally



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