Prior ills lead to early heart failure in blacks

NEW YORK (Reuters Health) - Heart failure before age 50 occurs up to 20 times more often among African Americans than among Caucasians -- and the root causes begin a decade or more earlier, a study indicates.

The findings show that heart failure was predicted by “the presence of hypertension, obesity, chronic kidney disease ... 10 to 15 years earlier,” the research team reports in this week’s New England Journal of Medicine.

Dr. Kirsten Bibbins-Domingo of San Francisco General Hospital, and others assessed the rate of heart failure over a 20-year period among 5115 subjects (52 percent black, 48 percent white; 55 percent female) who were 18 to 30 years old at enrollment in 1985-1986.

Of 27 cases of heart failure resulting in hospitalization or death that occurred during follow-up, all but one occurred in African Americans at an average age of 39 years, the team report.

Heart failure resulted in the deaths of three black men and of two black women.

The risk factors the study uncovered for early heart failure -- high blood pressure, kidney problems and being overweight -- “could become targets for screening and interventions aimed at the prevention of heart failure,” Bibbins-Domingo and her associates write.

For example, they estimate that “the number of young, black patients with hypertension that would need to be treated to prevent one case of heart failure before 50 years of age could be as low as 21.”

SOURCE: New England Journal of Medicine, March 19, 2009.