Chad Gradney underwent quadruple open heart surgery at the age of 27, after which he spent eight fruitless years battling extremely high cholesterol levels.
“That’s when I found out that three of the four transgressions had basically failed again,” recalls Gradney, now 44 and living in Baton Rouge, Los Angeles.
People with FH are primarily born with high levels of cholesterol that only increase as they age. About 1 in 250 people inherit the condition, according to the US Centers for Disease Control and Prevention.
But Gradney is also black, and FH tends to be significantly underdiagnosed and undertreated in black Americans compared to white people, experts say.
According to the nonprofit Family Heart Foundation, black people are diagnosed with FH at an older age than any other racial or ethnic group in America.
Research has also shown that black Americans with hyperemia are less likely to be prescribed cholesterol-lowering medications, even though natural lifestyle modifications aren’t enough to prevent heart disease in someone with a genetic disorder.
“It is very important to realize that people with FH are at risk not only because of their unhealthy lifestyle or diet,” said Dr. Keith Ferdinand, chief of preventive cardiology at Tulane University School of Medicine in New Orleans. “Many of these patients will need not just statins but three to five cholesterol-lowering medications.”
No one has checked for FH
Gradney says no one bothered to get him checked for FH after his first heart emergency, although nothing he did afterward seemed to lower him abnormally. high fat.
“The doctor wouldn’t directly blame me, but it was always something I didn’t do,” Gradney said. “My wife was a registered dietitian, so I felt like I had my healthy eating side well. I was taking my medication. I was active and exercising. But it was never enough.”
People with hyperemia have a 20 times greater risk of heart disease if they are not treated American Heart Association Says.
Men with hyperhydration develop heart disease 10 to 20 years earlier than expected, and women 20 to 30 years earlier, according to the American Heart Association. Half of men who are not treated for FH will have Heart attack Or angina pectoris before reaching the age of fifty.
“Unlike patients who develop high cholesterol later in life, these patients are born severely affected High cholesterol levels“Even during childhood, it’s not just how high cholesterol, but the length of time that cholesterol is high, influences heart disease risk,” said Dr. Anandita Kulkarni, a preventive cardiologist in Plano, Texas.
Suddenly his father left me Heart attack One morning in 2004. Five months later, he experienced chest pains that made him fear he was having a heart attack.
“I woke up one morning and my heart was going to explode, you know?” Gradney, who underwent open-heart surgery in 2005, said.
Eight years later, after learning he was in serious danger again, Gradney decided to take matters into his own hands.
Through his uncle, Gradney contacted a cardiologist at Johns Hopkins, who agreed to visit him. After three days of checkups, the doctor diagnosed him as having FH.
Once that was diagnosed, all the dominoes fell into place,” Gradney said. “Everyone knows what to do, and how to treat it. I was put on a strong prescription. Six months later, my levels were basically normal, probably for the first time in my life.”
Research has shown that Gradney’s struggle is not unusual.
Blacks are slightly more likely to have it than whites, with a prevalence rate of 0.47% compared to 0.4%, according to a 2016 study in the Medical Journal. Rotation.
Fewer black patients are getting standard treatment
But only 61% of blacks with hypercholesterolemia who are treated at private cholesterol clinics in the United States are prescribed cholesterol-lowering medications, compared to 73% of whites, according to a 2021 study published in the US. Journal of the American Heart Association.
Black patients also tend to have other untreated problems that increase the risk of heart disease, compared to white peoplestudy found. These include high blood pressure (82% vs. 50%), diabetes (39% vs. 15%) and smoking (16% vs. 8%).
structural racism and racism Kulkarni said are the most likely reasons for these disparities.
Kulkarni and Ferdinand said black Americans have limited access to cholesterol tests and medications. They are also less aware of the risks posed by the household.
Moreover, it is understandable that, [structural racism] “It has eroded trust toward the health care system among black individuals and communities. Together, this has led to disparities that affect not only the treatment of hypercholesterolemia, but moreover, the delivery and adoption of high-quality medical care,” Kulkarni said.
Experts recommend that blacks take proactive steps to protect their heart health, just as Gradney eventually did.
“Every adult should have their cholesterol checked,” Ferdinand said. “Know your cholesterol level.” “And if you have a family history of people who have had heart attacks and strokes, especially in their early fifties and early sixties, it is not enough to say that heart disease It runs in your family. You should receive a definite diagnosis.”
This is a job by Gradney. He has not visited the emergency room or spent another night in the hospital since receiving his diagnosis in 2012.
“My numbers are amazing,” Gradney said. “My last blood work, my total cholesterol was under 71, so that was amazing.”
“Be alert,” Gradney said. “Check it out. Take advantage of the resources out there.” “Don’t just accept that high cholesterol runs in the family. Stand up for yourself.”
The Family Heart Foundation has more about Black Americans and Heart Risk.
Anandita Agarwala et al, Racial disparities in modifiable risk factors and statin use in black patients with familial hypercholesterolemia, Journal of the American Heart Association (2021). DOI: 10.1161 / JAHA.121.020890
Sarah de Ferrante et al, Prevalence of familial hypercholesterolemia in the United States National Health and Nutrition Examination Surveys 1999 to 2012 (NHANES), Rotation (2016). DOI: 10.1161 / CIRCULATIONAHA.115.018791
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