Cardiovascular disease and race: What to know – Medical News Today

Heart disease is the leading cause of death in the United States. The risk of having or dying from heart disease varies by race. Black, Indigenous, and People of Color (BIPOC) are more at risk for complications from heart disease than white Americans. This includes a higher death rate and is partly due to the barriers to healthcare BIPOC groups face.

Heart disease accounts for about 1 in 4 deaths and claims 655,000 lives each year in the U.S.

The Centers for Disease Control and Prevention (CDC) state that heart disease is the biggest cause of death for most BIPOC living in the U.S., including the following groups:

This article explains how a persons race affects their risk for cardiovascular disease.

According to the same data from the CDC, heart disease death rates overall have fallen for white Americans since 1999. However, the rate of heart disease has remained consistent among Black, Hispanic, and Asian American groups.

Even though white Americans have the highest rate of heart disease diagnosis, they are less likely than Black Americans to die of the disease.

According to the CDC, cardiovascular disease death rates by race in 2017 were as follows:

While anyone can develop heart disease, certain risk factors increase the likelihood. These include:

However, BIPOC groups have a higher prevalence of certain conditions that raise their risk for developing cardiovascular diseases. These include:

A 2017 study that examined high blood pressure prevalence across racial and ethnic groups in New York City found significantly lower rates of hypertension among white Americans, with an overall age-adjusted rate of 27.5%. Black Americans had the highest high blood pressure rate at 43.5%, with a rate of 38% among Asian Americans and 33% among Hispanic Americans.

Within each group, there were also significant differences. For example, 43% of people from South Asia and 39.9% from East or Southeast Asia had hypertension.

Many factors other than genetics can lead to a higher risk of BIPOC developing high blood pressure, including racism in healthcare and everyday life.

For example, researchers in a 2014 systematic review concluded that exposure to perceived racist behavior could lead to an increase in the risk of developing high blood pressure.

Learn about hypertension in African Americans here.

Obesity is a significant heart disease risk factor. It may also signal other risk factors, such as a low-quality diet and an inactive lifestyle.

According to the CDC, 42.2% of white Americans have obesity, which means they have a body mass index (BMI) over 30. The rate for Black Americans is 49.6%, while Asian adults have the lowest rate, at 17.4%. Hispanic adults have the second-highest obesity rate, at 44.8%.

Higher poverty rates and residential segregation among BIPOC groups in the U.S. can cause higher rates of obesity. This is partly because they may not have easy access to fresh, healthier food and safe places to exercise.

A 2019 study tracked diabetes rates among 7,575 adults between 20112016. The age and sex-adjusted prevalence of diabetes was as follows:

Within groups, there was significant variation. For example, 12.3% of South American Hispanic participants had diabetes compared to 21.7% of Mexican participants.

These disparities happen due to a number of factors, including:

Learn about how these factors affect African Americans with diabetes in more detail here.

High cholesterol rates vary by race and ethnicity. The CDC reports that between 20152016, rates of high cholesterol were:

Race is a social construct based on skin color rather than genetics or biology. Even where genetic factors do play a role in heart disease, social determinants can affect the severity of the disease and a persons risk of dying.

Many of the risk factors that can lead to cardiovascular disease or complications from the conditions are preventable and exist because of systemic racism.

A number of modifiable factors could help reduce disparities between groups:

Racism causes chronic stress, which can increase the risk of developing heart disease. This occurs through weathering, a term that describes the long-term impact of exposure to racial stress on a persons overall health.

A 2019 study found that out of 2,694 people, weathering contributed to Black Americans having a biological age that was 2.6 years older than their actual age, while white Americans biological age was 3.5 years younger.

Racial stress can contribute to the development of disease, including risk factors for heart disease, such as high blood pressure. Directly experiencing discrimination also has this effect. For example, a 2004 study of heart disease rates in Black Americans found that the perception of racial discrimination at work correlated with developing hypertension.

It can be more difficult for individuals from BIPOC groups to access healthcare in comparison to white people. This is true for a number of reasons.

For example, residential segregation in the U.S. means that predominantly Black neighborhoods have fewer financial resources and are more likely to have shortages of doctors. It can also contribute to food deserts, which refers to areas where it is difficult to get fresh produce, and unsafe public spaces, which can affect a persons ability to exercise.

Economic inequity also contributes to healthcare being unaffordable for many, making it difficult to access or pay for medical treatment. For undocumented migrants, the fear of deportation can deter people from seeking help.

Numerous studies have found that individuals from BIPOC groups receive lower-quality healthcare than white people.

For example, in an older 2010 study of people seeking care for pneumonia, Black people were less likely to receive antibiotics within 4 hours. When they did receive antibiotics, the antibiotics were less likely to comply with treatment guidelines. There is no medical reason for this difference.

A 2018 study found that Black Americans are less likely than white Americans to get care from a cardiologist when they go to the intensive care unit for symptoms of heart failure. Care from a cardiologist correlated with a higher likelihood of survival.

In 2020, the American Heart Association (AHA) emphasized that structural racism is a key driver of disparities in heart disease and heart health outcomes. The organization called for more research on the health effects of racism and urged providers and organizations to examine their role within systemic racism.

One example of an organization that has committed to promoting antiracist policies is The Commonwealth Fund. Measures they call for include:

Systemic and unfair health disparities, or inequities, are something everyone has a responsibility to change. At an individual level, though, there are also things people can do to reduce their risk for heart disease. Where possible, people can try:

Learn how to follow a heart-healthy diet here.

In the U.S., the mortality rate for cardiovascular disease is higher among certain racial and ethnic groups than it is among white people. Conditions that elevate the risk of cardiovascular diseases, such as hypertension and obesity, are also more prevalent among BIPOC groups.

Evidence shows that the chronic stress, socioeconomic inequity, and discrimination caused by racism all contribute to this disparity.

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Cardiovascular disease and race: What to know - Medical News Today