Don’t shortchange this one life that you have
This February 22 is National Heart Valve Disease Awareness Day. As many as 11 million Americans have heart valve disease (HVD), which involves damage to one or more of the heart’s valves. While some types are not serious, others can lead to major complications—including death. Fortunately, valve disease can usually be successfully treated with valve repair and replacement in patients of all ages.
HVD can be there at birth, or develop from damage later in life from calcification, other cardiovascular diseases and conditions, or infection. Age is the greatest risk factor with 1 in 10 people ages 75 and older estimated to have moderate to severe HVD.
While heart valve disease is most prevalent in older adults, we know that African Americans tend to be younger than whites with the onset of heart valve disease risk factors, such as high blood pressure and diabetes. High blood pressure increases the likelihood of heart failure, a primary risk factor for heart valve disease, and African Americans develop heart failure before the age of 50 at 20 times the rate of whites.
But this doesn’t necessarily mean that heart valve disease is being detected early enough for effective treatments in African American patients. An August 2017 American Journal of Cardiology study found that the odds of being referred to a cardiothoracic surgeon for treatment of heart valve disease were 54% lower in African American patients compared with whites. Additionally, research shows that African Americans with heart valve disease are 33% more likely to refuse treatment than white patients. Yet, when they were treated, both groups had similar 3-year survival rates. The importance of understanding the reasons behind lower rates of referral and treatment refusal among African Americans cannot be overstated.
Additionally, some African Americans see health care as something to be used only when they feel symptoms, rather than for preventive medicine. In the case of heart valve disease, symptoms can include shortness of breath, chest pain, dizziness and fainting. Sometimes people with heart valve disease do not have symptoms, even if their disease is severe. For these people, a heart murmur is the most important clue. Delays in diagnosis and treatment of heart valve disease increase the risk of death, offering a cautionary tale for why African Americans must maintain a consistent relationship with a good healthcare provider who knows their medical history and provides preventive care, screenings, and referrals to specialists.
This why the National Heart Valve Disease Awareness Day campaign message “Listen to Your Heart” is so important. With attention to minimizing risk factors, and achieving timely diagnosis and early treatment intervention, more people with heart valve disease can have a better quality of life and live longer. As a country, we must invest in research for better heart valve disease treatment and care, as well as funding for outreach and awareness campaigns. We must also commit as individuals, families and communities to foster heart healthy habits, such as exercise, healthy diets and not smoking. Ending health care disparities can be achieved with education, awareness, and support for all patients and family caregivers and equal access to timely diagnosis and appropriate treatment.
Let’s not shortchange this one life that we have. During this month of heart disease awareness, let’s take time to talk to one another about becoming our healthiest selves. And importantly, talk to your physician about any heart valve disease risk factors or symptoms you may have, and don’t be afraid to ask your doctor questions about your treatment options. Listen to your heart, and together we can improve our aging outlook.
Aaron Horne, Jr., MD, MBA, MHS, is on the Association of Black Cardiologists’ Board of Directors, the Co-Chair of the ABC Structural Heart Disease Program and a structural interventionalist at Heart & Vascular Specialists of North Hills. Read the roundtable summary to learn more about the ABC’s efforts to address disparities in the care of minority patients with heart valve disease.