During the final week of exams, as Belinda Jenkins got dressed to go out with her sister, she was struck with an intense pain in her chest, which she dismissed as indigestion. But before she could pop a TUMS, she collapsed, crippled by the pain. As she lay on the ground gasping for air, she frantically managed to call 911, before losing consciousness shortly afterward. At 26, Jenkins was having a massive heart attack that nearly took her life.
Heart disease is a slow killer that usually catches victims off guard because they either don’t know their risk factors or they don’t recognize the warning signs, until it’s too late. There is even more shocking news: In a recent survey of 1,000 at-risk baby boomers, conducted by the Association of Black Cardiologists, 79% did not view cardiovascular disease as a major health concern. Only 23% believed they were personally at risk. Each year, approximately 1 million Americans have a heart attack, which accounts for 41% of all deaths in the United States. Heart disease is the leading cause of death for African Americans, especially women. According to the American Heart Association, 40% of African American women died from heart disease in 2000.
“It was literally a wake-up call for me to slow down,” says Jenkins, now a 27-year-old marketing coordinator for National Repro Graphics in New York. “I was doing way too much between work, school, and home.” Jenkins also suffered from Type I diabetes since the age of 2 and was very disciplined in minding her health. She took insulin shots, watched her diet, and kept fit through sports, even playing for the college volleyball team during her freshman year. But while attending college full time, she also worked full time to finance her education, and her hectic schedule took a toll on her health. At times, she ran on four hours of sleep and downed pizza for lunch — when she had time. “There was a lot of stress to be able to keep myself in college and also pay my bills,” she says.
It wasn’t long before she started experiencing classic symptoms of a heart attack. “Two weeks before everything occurred, I had been experiencing some tightness in my chest, some shortness of breath,” recalls Jenkins. “I’d wake up in the middle of the night with [my heart] racing in my chest, and I would just attribute it to maybe a nightmare or something.” These symptoms, her history of diabetes, and the fact that her entire family suffered from diabetes, made Jenkins a likely candidate for a heart attack, despite her young age.
“Diabetes is a much more powerful risk factor for heart disease in women than in men,” explains Dr. Jennifer Mieres, director of nuclear cardiology at North Shore University Hospital in Manhasset, New York. “There’s a three- to seven-fold increase of heart attacks in diabetic women compared to a two-fold increase in diabetic men across the board.” Two out of three people with diabetes die of some type of cardiovascular disease.
Diabetics don’t produce insulin, and without insulin, high levels of glucose build up in the blood. Glucose damages the walls of blood vessels and makes them ripe for the build-up of plaque, which constricts the flow of oxygen-filled blood to the heart. The heart, like any other muscle in the body, needs a healthy supply of blood to function. It struggles to perform when that flow is diminished.
Jenkins’ heart attack was caused by five blocked
Each year, about seven million Americans visit the doctor with complaints of chest pains. This universal symptom of a heart attack, chest pain, is not as common as was once thought. Some women, for example, don’t experience chest pain at all. Whatever the symptom, it’s best to seek medical attention right away.
arteries,, which required her to have quintuple bypass surgery. “Quintuple bypasses don’t happen a lot. You usually hear about a double, a triple,” says Jenkins. Her condition was so rare that doctors in the ER first thought it was a result of substance abuse.
“I showed up to the emergency room in a sweater, a pair of pants, and I had no socks on. I had no shoes on. I had no identification. I didn’t have a pocketbook,” says Jenkins. “They initially ran a toxicology test on me. They thought I was on drugs.” They ran an EKG test twice as Jenkins lay there for 45 minutes crying in pain and vomiting.
During her six hour-plus surgery, her heart and lungs were removed from her body and hooked up to a heart and lung machine, while arteries taken from her leg were used to replace the blocked ones in her heart. The incision
made on her inner thigh, running from groin to calf, is painfully and slowly healing. “When I first came home, I couldn’t even fold my leg at a right angle. Sitting at the table was not an option.” Her healing process will be long and slow, and facilitated by several medications — Zocor for cholesterol, Toprol for blood pressure, aspirin, folic acid for circulation, insulin, water pills to reduce swelling in her leg, and thyroid medication.Jenkins’ diabetes is impeding the healing process for her leg. “Diabetes takes a toll on your body,” she explains. Jenkins also suffers from thyroid disease, another illness that runs in her family. She was diagnosed 13 years ago after she stopped growing for a two-year period during her teens and inexplicably started gaining weight. Jenkins has recently tested positive for the Rheumatoid factor as well, which signals the possible onset of Rheumatoid arthritis, another autoimmune complication. She had also maintained high cholesterol levels since high school. “You don’t see a lot of high school kids on cholesterol medication, but at the same time, for preventative maintenance, it would have made some sense,” says Jenkins.
High cholesterol, diabetes, high blood pressure, stress, lack of exercise, family history of heart disease, and obesity are all connected and are high-risk factors contributing to heart disease. More than 70 % of black women are overweight and 49.7% are obese as opposed to 57.3% of white women who are overweight and 30.1% who are obese. In addition, 75% of African Americans do not have a healthy blood pressure (120/80 or below is considered healthy). These risk factors can be controlled through regular exercise and healthy diet, but for African Americans, our love of soul food and convenience foods has been difficult to balance. Combine that with the sedentary lifestyle of the overworked professional and you have several risk factors compounded. “Most of us are one generation away from a diet where [soul food] was viewed as the most desirable diet,” says Dr. Charles Francis, president-elect of the American College of Physicians and former chief of medicine at Harlem Hospital. “Those unhealthy lifestyles seem to have a much greater detrimental effect on African Americans than on whites.” Dr Francis suggests modifying traditional soul food dishes to include healthier ingredients and decreasing the amount of saturated fats, carbohydrates, and calories.
Jenkins tries to maintain a
healthy, low-sodium diet and gets more sleep than she used to. Although her diabetes heightened her risk for a heart attack, her hectic lifestyle also created a lot of stress, which can impact the body negatively as well. “If you’re not able to get rid of your stress, it stimulates negative metabolic activities in the body that leads to inflammation,” offers Dr. Arthur Beau White of BlackHealthCare.com and formerly the National Institutes of Health. “Stress in conjunction with improper dieting and improper exercise leads to coronary heart disease. It’s very simple.”People who have suffered a heart attack, especially diabetics, will most likely have future heart attacks. “The average bypass lasts only about 10 years, so it’s definitely possible that I’m going do this again before 40,” says Jenkins. “It’s no
t advisable that I have kids — ever — and that’s very hard to deal with.” Studies show that women are almost twice as likely as men to die after bypass surgery.
Women, particularly African American women, die at the highest rates from heart disease. Historically, women have been underdiagnosed and undertreated for heart disease. They have also participated in far fewer clinical trials than men.
But most people can avoid heart disease by simply eating right and exercising. In addition, knowing family history is key. “Even though you may be thin, if your mother died of a heart attack or had a stroke or has hypertension or diabetes, you should be tested, especially in families where heart disease is common,” says Francis. Some doctors are using a test that screens for the C-reactive protein, a marker of inflammation, especially on those who have a strong family history of heart disease.
Jenkins is helping to educate others about just such screening options, as well as their risk factors for heart disease by giving talks as a regional spokesperson for the National Coalition for Women with Heart Disease. “I may have had early detection if I was listening to my body and I wasn’t,” she remarks. Although she returned to work only two months after her surgery, against her doctor’s advice, she has slowed down her pace and is making a conscious effort to eliminate stressful situations and people. “My family was always complaining how I was never home. I don’t like not doing anything,” says Jenkins. “Nowadays I just really don’t have a choice. Sometimes I am so tired, I can barely move.”
Her ordeal has enlightened her about the scope and effect of heart disease, but it has also enabled her to become more introspective and reflective on her life and development as a person. “It made me look at trying to be more positive,” says Jenkins. “It’s taught me to reevaluate a lot of things and a lot of people in my life.”
General symptoms
- Pain, pressure, a squeezing sensation, or a stabbing pain in the chest
- Pain radiating to neck, shoulder, back, arm, or jaw
- Shortness of breath
- Weakness
- Unusual fatigue
- Nausea, vomiting, abdominal pain
- Cold sweats or clammy skin
- Dizziness
Women’s symptoms
- Unusual fatigue
- Body aches
- Overall feeling of illness
- Sleep disturbance
- Shortness of breath
- Indigestion
- Anxiety
Why You Need More Than An Apple A Day
The National Cancer Institute has launched a program to encourage Americans to eat more servings of fruits and vegetables each day. Recommended servings are 5 to 9. Only 4% of men and 14% of women eat the recommended amount. Research has shown particularly encouraging benefits for African Americans. Dr. Lorelei DiSogra, director of the National Cancer Institute and the National 5 A Day for Better Health Program, and Valerie Green, its nutrition program manager, share the researched benefits of adopting a diet rich in fruits and vegetables:
High intake of fruits and vegetables (8 to 10 servings per day) can lower blood pressure in one month. In fact, a study called Dietary Approaches to Stop Hypertension (DASH) showed that African Americans, of all the groups in the study, had the biggest drop in blood pressure from adopting a diet rich in fruits and vegetables.
Fruits and vegetables are high in potassium, a nutrient that will blunt the effect of too much sodium on blood pressure. Spinach, cantaloupes, brussel sprouts, mushrooms, oranges, grapefruits, and bananas are especially rich in potassium.
Eight to 10 servings of fruits and vegetables daily can help to lower LDL (bad) cholesterol, a major risk factor for heart disease.
Fruits and vegetables are naturally rich in folate — a B vitamin that lowers homocysteine levels, a risk factor for heart disease.
Antioxidants found in fruits and vegetables protect cells from damage and may help to avert the damage to arteries that leads to heart disease.