Article/Column

Survival test

by Congressman Elijah E. Cummings

The nation's news wires were on fire last week with a long-term research report by the National Institutes of Health.  The NIH study concluded that young African Americans are 20 times more likely to develop heart failure before their 50th birthday than are their white contemporaries.

Based upon a two-decade observation of more than 5,100 Americans of every race, the NIH's conclusion is deeply disturbing.  If these revelations about death in the prime of life do not galvanize a more decisive public response, it is difficult to imagine what would.

At the levels of both public policy and the protection of our own families, we have yet another survival test to overcome – and knowledge is the key.

We are a nation that has considered heart failure to be a widespread risk only for our elderly.  We also have believed that decades of work have reduced racially-based disparities in our health.

It is understandable, therefore, that the results of the NIH study were a shock.  In truth, however, they should not have been so surprising.

Our understanding about heart failure is far from complete.  Still, we already knew a great deal about this killer even before the NIH released its results.

Based upon national data, we knew that approximately 5 million Americans of all backgrounds would experience heart failure this year - and that 300,000 of us would die as a result.

We also have known for some time now that Americans of Color are living squarely in the bull's eye of this deadly target.  Cardiovascular illness is our most mortal threat - in both absolute and relative terms.

Eventually, one out of every four African Americans will die from a failing heart.  African Americans, ages 45-64, are 2.5 times more likely to die from heart failure than are Caucasians in the same age range.

Heart failure strikes most often when plaque (made of up fat, cholesterol, calcium and other substances) builds up in the arteries that supply our hearts with oxygen-rich blood.  If this coronary artery disease remains untreated, our hearts become unable to maintain the circulation of blood oxygen that we need to survive.

It is equally important for us to realize, however, that we have the ability to substantially reduce the number of premature deaths from heart disease in this country.  We need only to fully understand the risks, adopt healthier lifestyles and do what we must to assure that heart disease, when it does occur, is accurately diagnosed in its early stages and effectively treated.

Although the experts are not yet fully certain why so many African Americans are more susceptible to heart failure in the prime of life, this does not mean that they have nothing to tell us about saving our lives.
 
We know, for example, that dietary and other lifestyle choices are important.  African Americans' susceptibility to hypertension and excess weight gain are almost certainly significant factors in our increased mortality.
 
It is also clear that inadequate access to health care is a major factor that contributes to our early deaths. 

Since many people do not "feel" the impact of coronary disease during the early stages when it is most susceptible to effective treatment, an affordable health care plan that provides for testing is a critical survival tool.

The NIH's findings will also provide us with another powerful argument for expanded federal funding of the critical scientific research that can better determine why so large a percentage of African Americans are dying.  Several promising areas for that research have come to my attention.

For example, Dr. Mandep R. Mehra, Chief of Cardiology at the University of Maryland Medical Center, recently observed in the Baltimore Sun that his research has confirmed racially-specific differences in Americans' responses to the medication that is typically prescribed for heart failure.

In another promising example, Dr. Shenghan Lai at Johns Hopkins has analyzed the results of CT angiography scans of the hearts of 76 African Americans, ages 25-54, who had no symptoms or other observable signs of coronary artery disease.  He found that 16 of these test subjects (more than 21 percent) had coronary plaques.

"This made me exceptionally sad," Dr. Lai recalls.  "They did not know they were in trouble.  If we had not discovered their illness, the first symptom of their heart disease that they discovered could have been sudden cardiac death."

Something is desperately wrong with this picture.

We may not yet know the full answers to the questions raised by so many premature deaths, but our strategy for survival is clear.  It includes healthier diets, affordable supplements like Vitamin A, expanded access to high quality health care, and further medical research.

For more information about the research in this area, please give my office a call (410-685-9199).  You just might save your life or that of someone you love.

When it comes to meeting this survival test, we must do better.  To paraphrase the insightful words of Ms. Tracey Chapman: "Either we change, or we will live and die this way."

- The Honorable Elijah E. Cummings represents the 7th Congressional District of Maryland in the United States House of Representatives.