These details matter because there are certain cardiovascular conditions linked to genetic variants that are more commonly identified in Black people, and these variants are often linked to ancestry. Take transthyretin amyloidosis, for example. The condition, which can cause a buildup of abnormal protein deposits in the body, is associated with an increased risk of heart failure, and the gene that’s linked to it is generally identified in people of West African ancestry. An estimated 4% of Black people in the US carry the gene variant.3
Familial hypercholesterolemia (FH) is another relatively rare genetic disorder that causes high cholesterol at a young age, even as early as childhood. And the stats are telling: One in 192 Black people has FH compared to one in 323 white people.4
Certain risk factors also disproportionately affect Black people. Lipoprotein(a), a type of cholesterol that is associated with heart attack, stroke, and other forms of cardiovascular disease, is based on your genetics. Up to 25% of the world’s population is thought to have an elevated amount of this fat-carrying particle in their blood, but research suggests Black people, specifically those who have African ancestry, tend to have the highest levels.5
But as we mentioned, “genetics is just one piece of the puzzle,” Dr. Commodore-Mensah stresses. “Overwhelmingly, we know that your zip code is a better indicator than your genetic code when it comes to predicting cardiovascular disease.”
Systemic racism permeates throughout everyday life and in the health care system.
Social determinants of health also play a big role in skewing Black people’s heart disease risk, experts say. This term refers to the “nonmedical factors that influence health outcomes,” as the WHO puts it; they’re the conditions in which you’re born, live, work, and grow. All of these factors are shaped by economic and social systems (and it’s worth noting that these systems were built on racist policies that spanned decades and persist today).1 Social determinants of health include things like your financial situation, access to grocery stores and clean public parks, the ability to find an in-network doctor in your area, as well as feeling safe in your community.
Black people “experience greater social disadvantage” compared to white people, and this has a direct impact on their heart disease risk, the authors of a review published in the journal Circulation note. “Disparities in cardiovascular disease…are one of the starkest reminders of social injustices and racial inequities, which continue to plague our society,” they write.1
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