Cardiovascular disease in African American women: a health care disparities issue.

OBJECTIVES: To review the current status of cardiovascular disease (CVD) in African American women compared to Caucasian women in regards to 4 categories of CVD: coronary artery disease (CAD), hypertension, stroke, and congestive heart failure (CHF), and to call attention to the need to place more emphasis on the need to increase awareness of CVD as the greatest killer of African American females in the United States.
METHODS: A review of the recent literature on the subject of CVD in women over the past several years was conducted with a focus on CVD in African American women. Statistical data on incidence, prevalence, morbidity and mortality of CAD, hypertension, stroke, and CHF in black and white women were compared.
RESULTS: Statistical data gathered over the past several years indicate that African American women have greater mortality than Caucasian women from CAD, hypertension, stroke, and CHF. The mortality rate from CAD is 69% higher in black women than in white women. Mortality for black females from hypertension is 352% higher than for white females. Age-adjusted stroke death rates are 54% higher in African American than in Caucasian women, and the age-adjusted mortality rate per 100,000 is 113.4 vs. 97.5 for black and white women, respectively. Incidence, prevalence, and morbidity figures for CAD, hypertension, stroke, and CHF are all higher for African American females than for Caucasian females.
CONCLUSIONS: African American women are at exceptional risk for CVD, and more recognition of this fact as well as greater awareness of the problem should be promulgated and distributed by means of public education programs. Physicians who treat black patients also need to be encouraged to be more aggressive in their efforts to detect patients at risk and to initiate therapy early on in the course of CVD in this sub-population.