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Preventive medicine for African-Americans
African-Americans have much higher risks for heart attack, stroke, and certain types of cancer than do other ethnic groups. There are many reasons for this increased risk for disease, especially certain inherited factors that predispose African-American men to a higher risk for prostate cancer and high blood pressure, and certain hereditary factors (such as iron overload) which increase the risk for several diseases, including cancer, heart disease, arthritis, liver failure, and diabetes.
Preventive medicine for African Americans must include the following components:
Dietary advice
Assessment for cardiovascular disease
Assessment for hypertension
Assessment for diabetes
Cancer prevention
I will post additional information on this page soon. In the meanwhile, please take the time to scan over some of the research below, and call us at 713 520 8765 so that we can help you avoid disease by performing essential laboratory tests and helping you live the longest and strongest life possible!
please print and complete this form before your first visit
Primary iron overload in African Americans.
Wurapa RK, Gordeuk VR, Brittenham GM, Khiyami A, Schechter GP, Edwards CQ.
Department of Pathology, Case Western Reserve University, Cleveland, Ohio, USA.- Am J Med 1996 Jul;101(1):9-18
PURPOSE: To report African Americans with primary iron overload diagnosed during life and to study iron stores in African Americans undergoing autopsy. PATIENTS AND METHODS: We summarized information for 4 African-American patients diagnosed during life with iron overload not explainable by alcohol, blood transfusions, or ineffective erythropoiesis. We reviewed liver specimens and hospital records of 326 unselected adult African Americans who were autopsied, assessing Prussian blue-stained sections for hepatocellular iron and measuring iron quantitatively in specimens that stained positively. We calculated the hepatic iron index (the hepatic iron concentration in mumol/g dry weight divided by the age in years). In autopsy subjects we corrected the index to account for iron administered by blood transfusion (the adjusted hepatic iron index). The hepatic iron index is useful for distinguishing primary iron overload from the moderate siderosis that may accompany alcoholic liver disease. The normal index is < or = 1.0. An index > or = 1.7 cannot be explained by alcohol effects and an index > or = 1.9 indicates the magnitude of iron-loading found in Caucasian homozygous HLA-linked hemochromatosis. RESULTS: The 4 living patients, all males and 27 to 50 years of age, had elevated body iron burdens and one or more of the following: hepatomegaly, cirrhosis, cardiomyopathy, diabetes mellitus, and impotence. Hepatic iron indices were 2.3, 11.5, and 20.2 in the 3 whose liver iron concentrations were measured. Among the autopsy subjects, 4 (1.2%), 2 men and 2 women aged 50 to 63 years, had adjusted hepatic iron indices > or = 1.9 (range 1.9 to 5.6). CONCLUSIONS: Primary iron overload occurs in African Americans. Further studies are needed to define prevalence, pathophysiology and clinical consequences. Clinicians should look for this condition.
- Coronary heart disease in African Americans.
Clark LT, Ferdinand KC, Flack JM, Gavin JR 3rd, Hall WD, Kumanyika SK, Reed JW, Saunders E, Valantine HA, Watson K, Wenger NK, Wright JT. Division of Cardiovascular Medicine, State University of New York Health Science Center, Brooklyn, New York, USA.- Heart Dis 2001 Mar-Apr;3(2):97-108
African Americans have the highest overall mortality rate from coronary heart disease (CHD) of any ethnic group in the United States, particularly out-of-hospital deaths, and especially at younger ages. Although all of the reasons for the excess CHD mortality among African Americans have not been elucidated, it is clear that there is a high prevalence of certain coronary risk factors, delay in the recognition and treatment of high-risk individuals, and limited access to cardiovascular care. The clinical spectrum of acute and chronic CHD in African Americans is similar to that in whites. However, African Americans have a higher risk of sudden cardiac death and present more often with unstable angina and non-Q-wave myocardial infarction than whites. African Americans have less obstructive coronary artery disease on angiography, but may have a similar or greater total burden of coronary atherosclerosis. Ethnic differences in the clinical manifestations of CHD may be explained largely by the inherent heterogeneity of the coronary syndromes, and the disproportionately high prevalence and severity of hypertension and type 2 diabetes in African Americans. Identification of high-risk individuals for vigorous risk factor modification-especially control of hypertension, regression of left ventricular hypertrophy, control of diabetes, treatment of dyslipidemia, and smoking cessation--is key for successful risk reduction.
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- Kidney disease in African Americans: genetic considerations.
Price DA, Crook ED.
Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA. - J Natl Med Assoc 2002 Aug;94(8 Suppl):16S-27S
African Americans shoulder a disproportionately high burden of kidney disease when compared with white Americans. While environmental factors such as poverty and poor health habits, and the high prevalence of risk factors such as obesity, contribute to the high rate of kidney disease in this population, genetic factors may also contribute. Studies of polymorphisms in genes encoding the proteins of the renin-angiotensin-aldosterone system have identified alleles that are associated with kidney disease or changes in renal function in some populations. A higher prevalence of such alleles in African Americans may contribute to the increased prevalence of kidney disease. Diabetes mellitus and hypertension, the main causes of end-stage renal disease in the United States, are more prevalent in African Americans. However, no direct links between diabetic or hypertensive kidney disease and any genetic polymorphisms seen in African Americans have been identified. Further research is thus required to elucidate the genetic components that contribute to the high prevalence of kidney disease in African Americans.
- Kidney disease in African Americans: genetic considerations.
