BOSTON Heart failure may be about 20 times more common among young and middle-age blacks than whites in the United States, and it strikes blacks at a younger age, according to a 20-year study published on Wednesday.
"Blacks have heart failure rates in their 30s and 40s that we see in whites in their 50s and 60s," Dr. Kirsten Bibbins-Domingo of the University of California, San Francisco, said in a telephone interview.
With heart failure, a person's heart is unable to pump enough blood throughout the body. High blood pressure, diabetes and artery disease are among its leading causes. About 5 million people have heart failure and it kills about 300,000 people annually in the United States.
High blood pressure, obesity, kidney problems and a diminished ability of the heart to contract -- all seen earlier in blacks -- were key harbingers of the problem, Bibbins-Domingo and colleagues wrote in the New England Journal of Medicine.
"It speaks to the need to prevent these types of risk factors," Bibbins-Domingo said.
The findings for younger people come from a study known as CARDIA that started following 5,115 black and white volunteers when they were age 18 to 30.
Over two decades, 26 of the 27 people in the study who got heart failure were black. The average age of onset was 39.
"Young people are just not treated for their blood pressure. The barriers are at every level," Bibbins-Domingo said.
Problems include a lack of health insurance among some in that population, their feeling that they do not need to see a doctor, the reluctance of physicians to be aggressive in treating high blood pressure among patients in their 20s and 30s, and young adults' unwillingness to take medicine, the researchers said.
"In our study, almost 90 percent of blacks with high blood pressure didn't have it treated. It was the same for whites," she said.
By the study's 10th year, 57 percent of the black volunteers with high blood pressure were not taking their medicine for it and 19 percent still showed evidence of high blood pressure even though they said they were taking drugs.
Of all the people developing heart failure, 87 percent had blood pressure that was untreated or poorly controlled.
Earlier studies have concluded that blacks face a rate of heart failure that is up to twice as high as for whites, but those studies have usually involved people over age 55.
The people entered the study in the mid-1980s in Chicago and Minneapolis as well as in Birmingham, Alabama, and Oakland, California.
(Editing by Will Dunham and Vicki Allen)