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Clyde Yancy, M.D.: Take 6 Million Steps Against Heart Failure

Constant fatigue, no matter how much she slept, and passing out at the school where she worked led Rita Owens (Queen Latifah’s mom) to a heart failure diagnosis 10 years ago. She was surprised because she’d always led what she considered a healthy life.

Like Owens, nearly 6 million Americans are living with heart failure, which occurs when the heart muscle is weakened and can’t pump enough blood to meet the body’s needs. One in 5 Americans will develop the condition. More than 900,000 new cases of heart failure are reported each year and the numbers are rising. But awareness and understanding of the disease and its symptoms are low.

To combat this, the American Heart Association started the Rise Above Heart Failure initiative to increase the conversation about heart failure and improve the lives of those affected by it.

Black Health Matters spoke with Clyde Yancy, M.D., past president of the American Heart Association and chief of cardiology at Northwestern University Feinberg School of Medicine in Chicago, about heart failure and the Rise Above Heart Failure movement.

Black Health Matters: What exactly is heart failure? I don’t think many people understand the term.

Dr. Yancy: One very straightforward way to describe heart failure is any condition in which the heart is not working properly. For us to function, the heart needs to work for our benefit, whether that’s exercise or eating.

It is different from a heart attack, which is oftentimes the confusion. Heart attack can lead to heart failure. Heart attack implies immediate injury to the heart, typically because blood flow has been interrupted. With heart failure, the heart is simply a pump. If it stops working properly, that’s heart failure.

What are the symptoms?

Shortness of breath, swelling, fatigue, weakness. If you think about this, it really does sound like a condition a lot of people have as they get older. But too many times symptoms of heart failure are attributed to old age. There’s nothing about aging that should make you lose your ability to function properly. Your heart should function properly your entire lifespan.

I’ve heard it can be symptomless. Is this true?

Many times people will have a heart muscle that’s not functioning normally, but it’s doing it very quietly. Sometimes those symptoms can come on abruptly. For many people, the heart begins to work less well for a variety of reasons, but a person doesn’t realize it until they’re under some stress.

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If you feel like you’re not able to breathe comfortably, if you see you’re retaining fluid—even if you don’t have those symptoms, but are at risk because of diabetes, obesity or high blood pressure—you could have a heart that’s already damaged. We have research that shows [with all these conditions] you’re at an increased risk for developing heart failure.

How prevalent is this condition in African Americans?

It’s 50 percent higher in the African-American community, and it typically happens one to two decades earlier, during peak parenting years, during peak wage earning years. And it’s twice as likely to happen for African-American women. It’s driven largely by the burden of high blood pressure. African Americans have a 30 percent to 40 percent incidence of high blood pressure before the age of 40. That number is 50 percent by the age of 50. Their risk for heart failure is quite unique.

Why do we so rarely hear about heart failure? Why are we just talking about it now?

It wasn’t the disease of the day, but some of us have been talking about it for our entire professional career, we just finally have people listening! Traditionally, heart failure has been associated with aging. And it has been accepted as a natural consequence of getting older. People are resigned to you get old, your heart fails.

Once heart failure occurs, life expectancy changes, quality of life changes, the joy of living changes. And it doesn’t have to be that way.

Can we cure it? Treat it? How?

There’s a good news story; it’s not just another ‘we’re sicker’ story. We have many, many treatments that are not only appropriate, but also help you live longer. And we’ve learned how to prevent this condition from ever occurring.

We have so many more therapies now than we did 20, 30 years ago. We can’t cure it, but we can make people feel a lot better. And there are therapies that have been uniquely qualified to help African Americans.

What are those treatments?

Ones that help people breathe better, ones that reduce blood pressure. We have devices that help control heart rhythm and heart rate. Some surgeries. There’s a whole menu of treatment strategies we have now that we never had before.

Is Your Blood Pressure Too High?

You mentioned prevention. How do we prevent it?

The best way to prevent having heart failure, is to prevent having any form of heart disease—whether that’s heart attacks or high blood pressure. It’s seven really simple steps: Don’t smoke, be active, be the right weight for your height, eat a healthy diet, know your blood sugar, know your blood pressure, know your cholesterol.

If these are all in the appropriate place, we can look someone in the face and say quite comfortably, ‘you’re going to live a good life.’

Let’s talk about the Rise Above Heart Failure initiative ….

It’s just way cool! We’ve got this wonderful initiative that is spirited by the energy of Queen Latifah and the beautiful relationship she has with her mother, Rita Owens. It’s very genuine and very sincere. Queen’s mother has been living with heart failure for over a decade. She wanted to make it so other people wouldn’t be so mystified by this. So she partnered with the American Heart Association and we have launched this program. We want U.S. citizens to work with us in this campaign to take 6 million steps and let each step represent one of the lives of people in this country struggling with heart failure.

We want to show that with the right diagnosis, the right therapy, we can keep people alive longer and feeling better.

What’s should be our No. 1 takeaway about heart failure?

To the extent that everybody knows their cell phone number, that’s how well black folks should know their blood pressure. [With high blood pressure,] the risk for stroke is higher, the risk of kidney failure and the need for dialysis is higher. Heart disease is higher. If I know mine, and I’m very busy, then everybody should know theirs, as well.

This is not a ‘them’ problem. It’s an ‘us’ problem. We can prevent this burden of disease. It removes grandparents from families, parents from families.

Once heart failure occurs, life expectancy changes, quality of life changes, the joy of living changes. And it doesn’t have to be that way.

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