Coronary heart disease in African Americans: primary and secondary prevention
Luther T. Clark, MDAddress reprint requests to L.T.C., Division of Cardiology, Department of Medicine, State University of New York Health Science Center, 450 Clarkson Avenue, Box 1199, Brooklyn, NY 11203.
Obinnaya Emerole, MD
Coronary heart disease develops sooner in African Americans than in whites and causes a higher rate of mortality. Because multiple risk factors and risk factor clustering are common, efforts at primary and secondary prevention in this population need to address the total risk-factor profile.KEY POINTS
Cigarette smoking, hypertension, diabetes mellitus, obesity, left ventricular hypertrophy, and physical inactivity are all more prevalent in blacks than in whites. Further, according to the National Health and Nutrition Examination Survey, blacks are 1.5 times more likely to have multiple risk factors than their white counterparts. Diet, weight reduction and control, increased physical activity, smoking cessation, and other nonpharmacologic measures are the cornerstones of therapy and should receive special emphasis.
When pharmacologic therapy is required, selection of the drug to use requires consideration of benefits, concomitant diseases, costs, and effects of treatment on quality of life.