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Heart Health for Life

2011 African American Heart Health Tool Kit

Facts about African Americans, Cardiovascular Disease and Stroke

•            Cardiovascular disease, including stroke, is the leading cause of death for African-American men and women, killing nearly 100,000 annually. 

•            In 2007, among African Americans who died, cardiovascular disease was the cause of death in 32.0 percent of males and 35.4 percent of females. 

•            African Americans are almost twice as likely to have a first-ever stroke compared to Caucasians and more than 17,085 blacks die from stroke each year.

•            About 44.8 percent of non-Hispanic black men and 47.3 percent of women age 20 and older have cardiovascular diseases, according to the NHANES 2005-2008. (National Center for Health Statistics and the National Heart, Lung, and Blood Institute)

•            African Americans and Caucasians in the southeastern United States have higher death rates from stroke than those in other regions of the country.

Hypertension

•            The prevalence of hypertension among African Americans in the United States is among the highest in the world.

•            Compared to Caucasians, African Americans develop high blood pressure at an earlier age, and their average blood pressure is much higher. As a result African Americans have a 1.5 times greater rate of heart disease deaths and a 1.8 times greater rate of fatal stroke.

•            For non-Hispanic blacks age 20 and older, 43.0 percent of men and 45.7 percent of women have high blood pressure, a leading cause of stroke.

Cholesterol

•            Among non-Hispanic blacks age 20 and older, 37.0 percent of men and 41.2 percent of women have total blood cholesterol levels over 200 mg/dL.

Diabetes

•            Non-Hispanic black women have a 2 times higher prevalence of diabetes than non-Hispanic white women.

Weight

•            Among non-Hispanic black women, 77.7percent are overweight and obese,  51.0 percent are obese; 70.8 percent of non-Hispanic black men are overweight and obese and 37.0 percent of these are obese.

Physical Activity

•            Physical inactivity is more prevalent among African Americans than Caucasians.  Among non-Hispanic blacks only, 29.3 percent, are considered regularly active.

•            African Americans are one of the least active groups in terms of overall physical activity.

Cigarette Smoking

•            In 2009, 22.9 percent of black males and 18.8 percent of black females smoke cigarettes.

•            Research shows that cigarette smoking increases a person’s risk for stroke by 2 to 4 times.

Goals for a Longer, Stronger Life

•            Total Cholesterol                                   

Less than 200 mg/dL

•            LDL (bad) Cholesterol                                   

LDL Cholesterol goals vary:

- For people who don’t have heart disease and   only one or no risk factors, the goal is less than 160 mg/dL.

- For most people with two or more risk factors,  the goal is less than 130 mg/dL.

- For people who have heart disease, diabetes or are at higher risk for heart disease, the goal is to keep the LDL below 100 mg/dL. 

•            HDL (good) Cholesterol            

60 mg/dL or higher for women and 40 mg/dL or higher for men

•            Triglycerides           

Less than 150 mg/dL

•            Blood Pressure           

Less than 120/80 mmHg

•            Fasting Glucose           

Less than 100 mg/dL

•            Body Mass Index (BMI)           

Between 18.5 and 24.9 kg/m2

•            Waist Circumference           

Less than 35 inches for women and less than 40 inches for men

•            Physical Activity           

All adults should do at least 150 minutes a week of moderate-intensity physical activity or 75 minutes a week of  vigorously intense aerobic physical activity or a combination of moderate and vigorous.   Adults should do muscle-strengthening activities on at least 2 or more days a week. For example, you could do six to eight strength-training exercises, 8 to 12 repetitions each, twice a week.

•            Healthful Eating           

Emphasize a variety of fruits and vegetables, whole-grain, high-fiber foods, fat free or low-fat dairy products, fatty fish twice per week, legumes and sources of protein low in saturated fat (e.g., poultry, lean meats and plant sources) Limit added sugars and reduce sodium.

•            Tobacco Smoke           

If you smoke, STOP!  If you don’t smoke, DON’T START! 

•            Doctor Visits           

See your doctor regularly.  If a healthful diet and regular physical activity are not enough to reduce your risk of heart disease, ask about medication and take it as prescribed.  Even if you take medication, a healthful diet and physical activity are important.

Overweight and Obesity:

What You Can Do

•            About 112,000 deaths each year in the United States are associated with obesity.

•            67.3 percent of adults in the United States were overweight and obese according to NHANES 2005-2008.

•            Overweight and obesity are associated with heart disease, certain types of cancer, type 2 diabetes, stroke, arthritis, breathing problems and psychological disorders such as depression.

Physical Activity: Weight Control and Other Benefits

Regular physical activity helps weight control and weight loss when done in conjunction with a calorie-reduction eating plan.  Besides helping to control weight, physical activity helps reduce your risk for heart disease, including stroke.  It also helps to manage diabetes, slow bone loss associated with aging, lowers the risk of certain cancers and helps reduce anxiety and depression.

Physical Activity in the United States

Many people in the United States live sedentary lives.  In fact, only 34.9 percent of adults in the United States participate in regular physical activity.

Heart-Healthy Cooking Tips

Eating diets that are rich in fruits and vegetables, lower in salt, and lower fat (such as the DASH diet) have been shown to reduce blood pressure for many. Focusing your diet on foods such as fat-free and low-fat dairy fruits, vegetables and whole-grain, high-fiber foods is essential to good health.

Here are some tips to help make your meals healthful:

Frying

•            Steam, bake, broil or stir-fry foods in canola or olive oil instead of deep-frying in shortening or bacon grease.

Salt

•            Use vinegar, lemon juice, hot red pepper flakes, garlic and onions or other low-salt spices instead of salt.

•            Use little or no salt when you cook noodles, spaghetti, rice or hot cereal.

Salad Dressing

•            Use low-fat, low-calorie or fat-free salad dressings.

Butter

•            Use soft tub margarine instead of butter, or use other spreads that are lower in saturated fat, trans fat and cholesterol, such as a stick of margarine.

Eggs

•            Egg yolks are a major source of cholesterol; keep cholesterol less than 300mg per day.

Meat

•            Buy fresh lean cuts of meat and trim the fat before cooking.

•            Eat turkey, chicken and very lean beef or pork.

•            Remove the skin from poultry before cooking except when roasting a whole chicken.

•            Broil, bake or roast meats instead of frying them.

Oils

•            Use canola, olive, corn or safflower oil in cooking.

•            Use fat-free, calorie-free cooking spray to provide a non-stick surface for wokware, bakeware and grills.

Fat

•            Limit saturated calories to less than 7 percent of your total calories and trans-fat calories to less than 1 percent of your total calories.

How To Choose Foods Low in Saturated Fat

Using low-saturated-fat, low-trans-fat, low-cholesterol recipes makes it easier to cook healthful meals.  You can do a lot with your favorite recipes or everyday meals to control the amount of saturated fat and cholesterol you eat.

Here are some low-saturated-fat food substitutions:

Instead of:                                   

Whole milk (1 cup)                                                           

TRY Fat-free evaporated milk (1 cup)

Heavy cream (1 cup)                                                           

TRY Evaporated fat-free milk (1 cup)

Sour cream                                                                        

TRY Low-fat or fat-free sour cream            

Cream cheese                                                                       

TRY Low fat or whipped cream cheese

Butter (1 tbsp.)           

TRY 1 Tbsp. polyunsaturated margarine or ¾ tbsp. polyunsaturated or monounsaturated oil

Shortening (1 cup)           

TRY Tub margarine (1 cup)

Eggs (1 egg)           

TRY 1 egg white plus 2 tsp. of unsaturated oil

Unsweetened baking chocolate (1 oz)           

TRY 3 tbsp. unsweetened cocoa powder or carob powder and 1 tbsp. polyunsaturated oil or margarine.  Carob is sweeter than cocoa so reduce sugar in recipe by ¼.

How To Use Cooking Oils

When cooking requires using fat, use liquid vegetable oils::

•            To brown lean meats and to pan or oven fry fish and skinless poultry

•            To sauté onions and other vegetables for soup

•            In sauces and soups made with fat-free milk

•            In scalloped potatoes

•            For popping corn

•            In casseroles made with dried peas or beans

•            When cooking dehydrated potatoes and other prepared foods

How To Limit Salt (sodium) in Your Food

Eating more sodium  than the body needs can lead to high blood pressure in some people.  People with high blood pressure are more likely to develop heart problems or have a stroke.

•            Limit salt in cooking.

•            Use herbs and spices, instead of salt.

•            When using canned vegetables, drain the liquid and rinse them in water before cooking.

•            Read food labels carefully and choose products with reduced sodium or no added salt

•            Watch for high levels of sodium on the nutrition facts panel.

Know the Warning Signs of Heart Attack and Stroke

Warning Signs of Heart Attack

Some heart attacks are sudden and intense, but most start slowly with mild pain or discomfort with one or more of these symptoms:

•            Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.

•            Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.

•            Shortness of breath. May occur with or without chest discomfort.

•            Other signs. These may include breaking out in a cold sweat, nausea or lightheadedness.

Warning Sings of Stroke

The key to recognizing signs of a stroke is that they are SUDDEN:

•            Sudden numbness or weakness of the face, arm or leg, especially on one side of the body

•            Sudden confusion, trouble speaking or understanding

•            Sudden trouble seeing in one or both eyes

•            Sudden trouble walking, dizziness, loss of balance or coordination

•            Sudden severe headache with no known cause

If you or someone you know experiences any of the heart attack or stroke warning signs,

call 9-1-1 immediately. Check the time so you’ll know when the first symptoms started.  It’s very important to take action immediately. Getting to the hospital in time may help reduce the devastating effects of these medical emergencies.

Where to Get More Information about Heart Disease and Stroke

•            Talk to your doctor or healthcare professional.  If you have heart disease or have had a stroke, members of your family may also be at risk.  It’s important for them to make changes now to lower their risk.

•            Call 800-AHA-USA1 (800-242-8721) or browse americanheart.org to learn more about heart disease.

•            Call 888-4-STROKE (800-478-7653) or visit strokeassociation.org to learn more about stroke.

GO RED

Today is Go Red for Women day to eradicate heart disease.

In March 2010 I had Open Heart surgery to repair my aortic valve.  It was a tremendous success and less than a year later; I'm happy to report my heart and my health is is perfect working condition.  I believe that we must all "pay it forward" when given the opportunity. So in an effort to promote heart health in women and people of color, I have become The American Heart Association's National Volunteer.  My commitment is to expanding awareness of the mission of the Heart Association as it relates to women and people of color.

Today we focus on Going Red for Women!

Women and Cardiovascular Disease Facts
(provided by The American Heart Association)

Overview

More women die from heart disease, stroke and other cardiovascular diseases (CVD) than men, yet many women do not realize they are at risk. These diseases kill more women each year than the next five causes of death combined.

The contributing factors for this epidemic include:

Lack of knowledge
Women and their healthcare providers do not know the biggest healthcare threat to women is heart disease.  A 2006 survey conducted by the American Heart Association found that 43 percent of women are unaware that heart disease is the leading cause of death among women.

Although women of color and of low socioeconomic status are disproportionately affected by heart disease — the death rate was 28 percent higher for black women than for white women in 20051 — only 31 percent of black women and 29 percent of Hispanic women knew that heart disease was their greatest health risk, compared to 68 percent among white women.

Among primary care physicians, only 8 percent knew that more women than men die each year from CVD.

Many women do not recognize the warning signs or symptoms of heart disease and stroke, which may be more subtle than those exhibited by men.  Lack of awareness often results in less aggressive and sophisticated diagnosis and treatment by women's health care providers, with worse outcomes.

Gender Differences
Researchers have learned that gender differences play an important role in the prevention, diagnosis and treatment of CVD.  Heart attack symptoms may present differently in women than in men6 and they may also respond differently to cardiac medications

Although chest pain is the most common heart attack warning sign in both men and women, women may be less likely than men to report chest pain during a heart attack and more likely to report other symptoms, often resulting in misdiagnosis and delays in treatment.

Women tend to develop CVD later in life than men, and their outcomes are often worse.  An exception is women smokers, who die of a heart attack caused by smoking earlier than men.

Women with acute coronary syndrome are more likely to have adverse outcomes, including death, heart attack, stroke, or rehospitalization, even after adjusting for age differences.

Previous studies and clinical trials have often been done with inadequate numbers of women in the study population, and thus their conclusions do not always apply to women.  Women represent just 38 percent of subjects in NIH-funded cardiovascular studies.  In addition; three-fourths of cardiovascular clinical trials do not report sex-specific results, making it difficult for researchers and clinicians to draw conclusions about their effects on women.

Researchers have identified gender differences in response to cardiac medications. Drugs that are beneficial for men may even be harmful to women. For example, the drug digoxin used to treat patients with heart failure was associated with an increased risk of death among women but not among men.

Diagnosis and Treatment Disparities
Women are less likely than men to receive aggressive diagnosis and treatment for CVD.

Women who are at risk for CVD are often not referred for diagnostic testing that would be standard in men.

Among Medicare patients, men are two to three times more likely than women to receive an implantable cardioverter-defibrillator for the prevention of sudden cardiac death.

Only about 31 percent of all percutaneous coronary interventions, with and without stent insertions, were performed on women in 2005.

Note:  This information is also available in a downloadable pdf format.