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Genes Linked to Black Heart Failure
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By JANET McCONNAUGHEY
Associated Press Writer

October 9, 2002, 5:25 PM EDT

A genetic double-whammy rarely found in whites dramatically increases
the risk of congestive heart failure in blacks and may help explain why
they are more likely than whites to get the disease, researchers say.

The genetic combination plays a role in one-quarter of the cases of
congestive heart failure diagnosed each year among blacks, said Dr.
Stephen B. Liggett, a leader of the study.

The study found that a pair of genes that does nothing bad by itself can
double the risk created by a second pair, generating a tenfold risk for
heart failure in black people who have both.

About 5 percent of U.S. blacks have that combination, Liggett said. But
it is far rarer among whites.

The study was published in Thursday's New England Journal of Medicine.

Doctors have long known that blacks are more likely than whites to
suffer from heart diseases and certain other illnesses, and are more
likely to die from them. Some researchers have suggested that blacks
receive inferior care, perhaps because of unconscious prejudice among
doctors.

In fact, an analysis of 81 studies, released Wednesday as part of a
campaign by major health foundations to close the racial health gap,
found that the evidence that minorities get inferior cardiac care is
compelling.

Liggett's study, however, is part of a growing body of research
indicating that at least part the racial gap can be explained by
genetics.

Nearly 4.8 million Americans have congestive heart failure. It affects
about 3.5 percent of all black men, 3.1 percent of black women, 2.3
percent of white men and 1.5 percent of white women, according to the
American Heart Association.

That would mean about 733,500 blacks have the disease. It shows up
earlier and is more likely to have serious complications in blacks than
in whites. Also, blacks do not get as much benefit from ACE inhibitors
and beta-blockers, two common groups of medicines for heart disease.

There is no one explanation for those differences. What you do and where
you live also can increase the risk. High blood pressure, diabetes, high
cholesterol, smoking and obesity all make it more likely.

That means people who have both gene pairs should do everything they can
to eliminate the risks they can control, Liggett said.

One of the gene pairs in question increases production of a chemical
that increases blood pressure, heart rate, and the heart's contraction
and relaxation. The other gene pair makes heart cells which take up the
chemical, norepinephrine, more sensitive to it.

Since the pair producing excess norepinephrine is 10 times as common
among blacks as among whites, the combination is also far more common
among blacks.

In the study, two of the 84 healthy blacks had the combination, compared
with 15 of 78 blacks with heart failure. Two out of 105 healthy whites
and three of 81 with heart failure had the gene combination.

Copyright (c) 2002, The Associated Press

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