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Black Women’s Risk for Heart Disease Seen at Younger Ages

CardioSmart News

High rates of obesity, high blood pressure and other lifestyle-related factors among many Black women earlier in life may be putting them on a worrying path to develop heart disease at a young age, according to a study presented at the American College of Cardiology’s 70th Annual Scientific Session.

While previous research has drawn attention to the burden of heart disease among Black women, the new study is unique in its focus on when heart disease risk factors emerge. The researchers found high rates of lifestyle-linked risk factors – for example, being overweight or obese or having elevated blood pressure – among Black women as early as in their 20s and 30s.

“Young people should be the healthiest members of our society,” said Nishant Vatsa, MD, an internal medicine resident at Emory University Hospital in Atlanta and the study’s lead author. “We’re finding obesity and elevated blood pressure are present in [these] women even at younger ages, which is worrisome. Interventions like educating young women about healthy dietary choices and the benefits of exercise, improving access to health care and enhancing the ability for people to adopt healthy practices – such as increasing access to healthy foods and safe areas for physical activity – needs to start early.”   

Researchers analyzed data collected in 2015-2018 from 945 Black women enrolled in a community health screening project in Atlanta. They assessed health markers such as body mass index (BMI), blood pressure and cholesterol levels; socioeconomic factors such as education, income and health insurance; and lifestyle factors such as smoking, diet and exercise.

The average BMI for women of all age groups was 30 or above, a level considered clinically obese. Systolic blood pressure levels, a measure of the force at which blood pushes against the artery walls during a heartbeat, increased with age. From ages 20-39 years, Black women had an average systolic blood pressure of 122 mmHg – higher than the 120 mmHg considered normal. Systolic blood pressures worsened in older age groups, where middle-aged and older women had an average systolic blood pressure of nearly 133 mmHg and 142 mmHg, respectively.

Obesity and high blood pressure are key risk factors for heart disease. Both are known to be influenced by lifestyle factors such as diet and exercise. Nearly 1 out of 3 women aged 20-39 reported eating fast food at least three times per week, and 2 out of 5 consumed more than the recommended amount of salt daily. These proportions were also high in middle-aged women but lower among those older than 60.

Based on the findings, Vatsa said there should be a call for increased attention among clinicians and the public health community to help young Black women maintain their weight and blood pressure within a healthier range through lifestyle changes and medications when warranted.

“Diet and exercise play a major role in blood pressure and weight,” Vatsa said. “Primary care providers, prevention-based clinics and community organizations can facilitate interventions proven to mitigate these risk factors. Providers that treat young Black women need to be mindful of cardiovascular preventive care and be armed with resources and education.”

He added that the coronavirus pandemic, which has disproportionately affected Black and other minority communities, has revealed and exacerbated the barriers Black women face in accessing preventive health care. Increased attention to reducing barriers in health care and to the adoption of a heart-healthy lifestyle can improve health in the near term and reduce the burden of heart disease for decades to come, he suggested. 

One limitation is that the study didn’t include women younger than 20, and some of these risk factors may emerge at very young ages.

For resources on women and heart disease visit CardioSmart.org/Women.

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