Genetic Link for Heart Failure Found, Could Explain Higher Rates in African Americans

A combination of two pairs of genes rarely found in whites increases the risk of congestive heart failure in blacks and plays a role in one-quarter of cases of the disease diagnosed among blacks, according to a study published in today's New England Journal of Medicine, the AP/Washington Post reports (AP/Washington Post, 10/10). For the study, researchers at the University of Cincinnati compared 159 patients with congestive heart failure with 189 people who were "similar in other respects," including race, but did not have the disease (Kolata, New York Times, 10/10). The study specifically examined the combination of two pairs of genes that are found in about 5% of African Americans but are not nearly as common in white people, according to Dr. Stephen Liggett, the study's author. The study found that 15 of 78 black participants with congestive heart failure had the gene pair, compared to only two of 84 healthy black participants. Three of 81 white participants with heart failure had the gene combination, compared to two of 105 healthy white enrollees (AP/Dallas Morning News, 10/10).

The study is "part of a growing body of research" that indicates the higher occurrence of heart failure in blacks might be explained in part by genetic differences, the AP/Post reports. However, Clyde Yancy of the University of Texas Southwestern Medical Center at Dallas said, "When you control for ... variables" such as discrimination, lack of access to care and "other societal inequities, ... there is still more heart disease in African Americans" (AP/Washington Post, 10/10). The study raises "provocative questions" about whether genetic screening should be used to determine risk for certain diseases, the Wall Street Journal reports. In an accompanying editorial, Roger Hajjar, assistant professor of medicine at Harvard Medical School, writes that more in-depth studies on the topic are needed (Zimmerman, Wall Street Journal, 10/10). The study's abstract is available online.

In related news, the Kaiser Family Foundation and the Robert Wood Johnson Foundation, in partnership with the American College of Cardiology Foundation, the American Heart Association and the Association of Black Cardiologists as well as co-sponsoring organizations representing medical, public health and business interests, yesterday announced a campaign to "clos[e] the gap" in heart disease treatment among racial groups, the Houston Chronicle reports. As evidence of the need for such a campaign, Kaiser and the American College of Cardiology released a review of 81 medical studies, 68 of which found that minority patients receive inferior care compared to white patients. Eleven of the studies found no differences in care and two of the studies found minorities receive better care than whites (Lee, Houston Chronicle, 10/9). As part of the campaign, the coalition from now until March will place advertisements in 10 leading medical publications "alert[ing] doctors to the issue" and will highlight a Web site that focuses on the topic. "The data are sufficiently compelling to begin undertaking actions to systematically and aggressively eliminate disparities in needed medical care," RWJF Senior Vice President Dr. Risa Lavizzo-Mourey said (AP/Nando Times, 10/9).