African Americans are twice as likely to suffer from sudden cardiac death compared to whites — that rate is triple for black women. A new study published in the Dallas-based American Heart Association’s journal 'Circulation' shows that risk might be tied to income and education disparities.
Dr. Eliseo Guallar is with Johns Hopkins University's Bloomberg School of Public Health. He is also the lead author of the study and joins KERA's Justin Martin for a look at their research.
On sudden cardiac death: Sudden cardiac death is when someone dies unexpectedly without having had symptoms in the previous days. There are questions about the timeframe, but typically someone who dies and had not had symptoms in their prior 24 hours that would be considered sudden cardiac death.
On why blacks suffer from a higher lifetime risk: We don't know all the reasons why, but we know that unfortunately African Americans are a disadvantaged group for many health endpoints, including cardiovascular disease in general. In addition we found that income and education also explain some part of it.
Although we studied a number of risk factors, there were some differences that we could not explain. So, there might be some additional reasons that we could not identify.
On how income and education affect the study: As you can imagine it's a combination of things. Income, same as socioeconomic status, is what we would call upstream risk factors, which means that they influence many other factors down the line. So if you have limited resources — if your income is low — your diet is going to be worse, you're going to have less access to healthier foods, probably your opportunities for exercise are going to be also lower, your control of risk factors such as hypertension is also probably going to be worse. You might be less likely to consult with a physician or to take medications, in addition this is also related to education and in particular to health care related education.
This was not from our study but people are also finding that services in low socioeconomic areas, health services are also not us quick to get to patients who have cardiac arrest and then the outcomes in these patients can also be worse than in other patients. So it's a combination of things, and the total impact is probably very substantial.
On higher income people having less heart-related issues: So, it's the other side of the coin. People with higher incomes have access to much better diets, they have a much healthier lifestyle. They have much stricter control of cardiovascular risk factors, so if they have hypertension they get it control through different medications, same thing if they have diabetes — they get better control of their disease. So in the end all of these issues over many years add up and create a huge difference.
On how racial discrimination or segregation plays a role: I think there's no question about that. Our study doesn't have specific data to address that, but in my mind and I think in the mind of many people doing these types of studies there's no question about that.
On future plans for the research: I think there are a couple of issues. I think one of the things we want to do is increase awareness of this, and second issue is that we want to try to understand better what the specific components of education and income are that can make a difference.
Dr. Eliseo Guallar is with the Johns Hopkins University Bloomberg School of Public Health.