South Florida Hospital News
Tuesday December 11, 2018
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February 2006 - Volume 2 - Issue 8

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Helping Stop Heart Disease in Minorities

This month, as South Florida Hospital News salutes minorities in healthcare, we at the Florida Heart Research Institute felt it would be an opportune time to share with you our efforts in addressing some of the critical issues surrounding cardiovascular disease in minorities. It is well-known that the pattern of cardiovascular disease is not uniform among different ethnic populations. Although, cardiovascular disease is the leading killer of men and women in every ethnic group, the risk of dying from it is higher among African-Americans and Native American Indians than it is among non-Hispanic whites. The benefits of a decreasing mortality rate in recent years has not been realized by either of these populations. The data on Hispanic populations is highly variable, depending upon which population—Mexican, Cuban, South American—is being studied. In certain cases, there is a clear genetic component to the problem, such as the unusually high prevalence of diabetes and early atherosclerosis in the Pima Indians (and perhaps other Native American tribes). On the other hand, although it is well known that hypertension and diabetes are both more common in the African-American than in the Caucasian populations, it is less clear whether this can be attributed solely to dietary and life-style decisions, or whether there exists a genetic component as well.

The controversy is not trivial, as the response to certain anti-hypertensive medications seems to vary between races. The relative emphasis as well as ideal methodology for treating risk factors may in fact vary between different populations. Unfortunately, the higher incidence and mortality of cardiovascular disease in certain populations reflects not only gaps in our knowledge, but clear discrepancies in the delivery of care. The Indian Health Service is clearly overwhelmed by the high rates of poverty, unemployment, alcoholism and other social problems which accompany and aggravate efforts to improve the health of Native Americans. Likewise studies have documented discrepancies in the delivery of health services to America’s African-American population.

For these compelling reasons, the Florida Heart Research Institute is actively engaged in efforts both to improve our knowledge, and to improve public awareness and health care delivery in underserved populations. Since we have the good fortune to be located in the diverse community of South Florida, we have embarked upon a study of early congestive heart failure in multiple ethnic groups—focusing especially on a rich experience with the Hispanic population here in Miami. In collaboration with the Mayo Clinic, we are evaluating the long-term prognostic value across ethnic lines of various potential markers—the natriuretic peptides, cardiac echocardiography, highly specific C-reactive protein—in asymptomatic individuals. Such information could be used to prevent the development and consequent devastating mortality and morbidity from congestive heart failure in high risk individuals before they get into trouble.

Similarly, FHRI has received a prestigious grant from the Blue Foundation for our "Mission to Health" program—a grassroots and collaborative community outreach program to educate the at-risk local Pan African communities on preventive measures that can be employed to reduce their risks for chronic diseases. Through a partnership with local churches, the Miami-Dade County Health Department, Economic Opportunity Family Health Center, the Community Access Program and other concerned individuals, the Research Institute will be providing cardiac screenings and education to at-risk underserved communities, while providing follow-up education and retesting to assess the impact of our efforts. It is our hope that this program will serve as a successful public health model for chronic disease prevention among this hard to reach ethnic population.

We join Hospital News in saluting the minorities involved in health care, and roll up our sleeves to work together on the long, arduous and productive process of better understanding and serving these diverse populations.

Dr. Paul Kurlansky, board certified cardiothoracic surgeon, Director of Research at the Florida Heart Research Institute, can be reached at (305) 674-3154 or DoctorWu18@aol.com.
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