A_Failing_Heart

A Failing Heart: The Link between Diabetes, Hypertension, and Heart Failure Quintasha Williams ANT 101 Arunima Kashyap December 23, 2009 Compared to the general population, African Americans suffer more from hypertension and diabetes than any other ethnic group in the country. Diabetes is a disorder that affects the way your body uses food for energy. Blood pressure is created by the force of the blood pushing against the walls of the arteries as it circulates and the force of the arteries as they resist the blood flow. High blood pressure makes the heart work harder to pump blood throughout the body and causes damage to the blood vessels. Heart failure is a condition in which the heart is not pumping blood through the body the way that it should. High blood pressure and diabetes are two of the leading causes of heart failure. Anyone battling one or both of these diseases is also at an even greater risk of causing serious damage to their heart if they are not treated. My attraction to this topic comes from the experiences within my family. I come from a long line of men and women that suffer from diabetes, high blood pressure, kidney disease, and heart failure. My brother Diante has always been a chunky, thirsty kid that can eat just about anything. He would drink a gallon of milk, two and a half gallons of water, and juice everyday. In the summer of 1994 he lost a total of 60 pounds in 55 days, none of is eating habits changed, and he was never one to exercise. On July 10, 2009 he had taken a shower and was getting dressed for bed when he felt dizzy and passed out on the floor in his room. When he woke up he was being loaded into an ambulance. Once admitted to Cook County Hospital in Chicago, he was treated for high blood pressure, which was brought on my obesity, and type-1 diabetes. The doctor explained that that people with type-1 diabetes can not produce insulin. The glucose can't move into the cells and blood glucose levels can become high. Over time, these high glucose levels can cause serious complications. Type-1 diabetes is a chronic, the cause is not known, and every individual needed unique care to prevent other serious complications like stroke, and heart disease from happening. With a new diet and a change in his exercise routine, Diante is now managing his diabetes, and no longer has high blood pressure. The situation that was just described has been going on within the African American culture for decades. The American Heart Association says, “Diabetes is associated with an increased risk for a number of serious, sometimes life threatening complications, and certain cultures (mostly African American) experience an even greater threat. Good diabetes management can help reduce the risks; however, many people are not even aware that they have diabetes until they develop one of its complications” (ADA, 2010). So, in essence you could very well live with this disease and not know its hurting you until you almost die from it. Some experts believe “race” is the primary determining factor for who will develop heart failure. Most of them also agree that the combination of high blood pressure and diabetes, two conditions said to be both genetic and environmental, play a much greater role than “race” does. The latest study from the cardiologists at Johns Hopkins show that each year, nearly 300,000 Americans die from heart failure (2007). The majority of the items in the study pointed to the rate that heart disease is developed, as opposed to what can be done to decrease the risks of getting the disease. There is too much attention being placed on the amount of people within the African American culture that suffer from heart failure, instead of the treatment of the illness is sadly amazing. Every article tells you what hypertension, heart disease, and diabetes are, but none of them say why you have to almost die from it before it is detected. There are several statistical breakdowns on the percentage of Blacks, Hispanics, Caucasians, the have been diagnosed with these diseases. Each study done over the past 25 years show African Americans ranking as the highest group to suffer from these illnesses. For example: [3.7 million, or 14.7% of all African Americans aged 20 years or older have diabetes. African Americans are 1.6 times more likely to have diabetes as non Hispanics. African Americans are more than a third more likely to have high blood pressure than Caucasian Americans. Heart disease and stroke account for about 65% of deaths in people with diabetes, (ADA, 2010).] The answer given as the cause for each of these diseases is genetics and the environment. None of these statistics show positive highlights where the survival rate increases with time, only the gloom of what’s to come of the disease that has no true genetic pool to pull from to show the root cause of these issues. High blood pressure, the disease that has been named “The Silent Killer” for many years, had no drugs available for its treatment until 1955. African Americans used home remedies like eating 2 to 3 tablespoons of mustard and a couple of glasses of water, to relieve the headache that was brought on by high blood pressure. An Amsterdam news article by Gerald W. Deas (July 30 -Aug 5, 2009) reads, “When you consider that the gene pool of African Americans is made up not only from the gene pools of Europeans, but also Native Americans as well as Africans from different parts of Africa, it is obvious that their responses to medications might be clinically different. When drugs are being tested on a population, the African American is not used in any statistical numbers, and therefore it is obvious that the outcome of that drug would not represent our gene pool” (pg. 26). After all of my reading of the statistics and other new surrounding the link between diabetes, high blood pressure and heart failure, I have to agree with his comments whole heartedly. African Americans suffer more because we are not included in the testing being done to prevent these diseases for taking over our culture. One leading researcher said, “Warding off heart failure in African Americans requires aggressive treatment of diabetes and hypertension. Whether through increase screening, or greater emphasis on drug therapies, these are two risk factors that must be brought under control” (Bahrami, 2007). Over the years it has been proven that Africans Americans, as well as any other culture, can overcome the life threatening risks of heart disease with a positive mindset, proper diet and exercise. Still, there are so many questions that will go unanswered. Why are diseases like high blood pressure and diabetes being labeled as genetic, when it is unclear which gene pool produces the specific disorder' Why are we are only being categorized by the rate in which we acquire these disease, and not by how many of us survive with it' When will more trial studies, including African Americans, be done to prevent death due to diabetes and kidney disease' I do believe that if we want to see fewer deaths from heart failure; it is necessary that another hard look at the way these diseases are treated be done most expeditiously. There should more focus on the cure for these diseases during a clinical study, and less on the environment, income, and socioeconomic status of a specific culture. My introduction to cultural anthropology has been an amazing journey. While taking this class I have found out some wonderful things about my heritage, the culture and way of life of my ancestors, and my personal link to heart disease. At the beginning of December 2009, I was diagnosed with high blood pressure. Before I could absorb the words, my mind raced back in time over every illness I could think of through out my entire family. I think the stress from the thinking alone may have increased my blood pressure by ten points. After I pulled myself together, I took a minute to put my thoughts in order. In hindsight, there were always some spots of health concerns like, constant fatigue, shortness of breath, fluctuating weight, irregular sleep patterns, obesity, etc. Despite these signs, I never thought for a moment that I could be at risk for high blood pressure and possible heart failure. Just like much of the articles I’d been reading over the past few weeks, my doctor explained that the disease was genetic. He then stated that we may have to try several medications before we find one that works because high blood pressure was hard to manage in African Americans. I was given one brand of medication the first week, followed by a request to purchase a home blood pressure machine. I was to monitor my blood pressure at home and report the results to my doctor. A second brand of blood pressure medication was given in the second weeks visit. Each visit for 3 weeks showed no improvement in my blood pressure. When the doctor tried to offer a third medication, I became so irritated with the fact that there wasn’t just one medication that I could take to manage my blood pressure, that I stopped taking the medication, and switched doctors just to get a second opinion. When I went to visit my new doctor, I explained the readings I was getting at home (which averaged about 132/86), and that they did not come close to what I was getting in the old doctor’s office (172/112). Much to my surprise, it was discovered that the previous nurse responsible for taking my blood pressure was not taking it with the correct cuff size (x-large), but was doing so with the wrong size cuff (med/large); thus, causing multiple false elevated blood pressure results. I wondered how many times this same thing has happened to other African Americans that were searching for some explanation as to why this disease was being glossed over with assumptions like; its genetic. Needless to say, my medication was reduced to one small dose to be taken twice a day for 6 months, and the stress of falling down a barricade of endless medication was relieved. In conclusion, my research on this topic has raised my level awareness regarding the link between hypertension, diabetes and heart failure in many ways. Thanks to all the articles, journal entries, and medical reviews, I am on a great road to losing weight and making healthier food choices. Also, I have prepared a presentation of a combination of the studies I’ve read to share with my family. It highlights the early warning signs of high blood pressure and diabetes, it explains what happens to the heart when these diseases go untreated, and lastly what we can do as a family, a community, and a culture to get in shape, change our eating habits, and progress positively while living a healthier life. Hopefully the word of our progress will spread beyond our culture and into the world to show that with patience, determination, motivation, and confidence, anything is possible. References Deas, G. W. (2009, Jul 30-Aug 5). What’s up with high blood pressure in African- Americans' New York Amsterdam News (Vol.100) Is. 31; pg. 26. Abstract retrieved December 21, 2009, from ProQuest Direct database. Loft, A. M. (Nov 2009). Black Enterprise. (Vol. 40) Is. 4; pg. 82. Abstract retrieved December 21, 2009, from ProQuest Direct database. March, D. (2007, Mar 31). Diabetes and High Blood Pressure: A Greater Role than Race In Determining Who will develop heart Failure. Medical New Today on the Web. Retrieved December 21, 2009 from www.medicalnewstoday.com www.diabetes.org