Nav: Home

Pregnancy-related heart failure strikes black women twice as often as those of other races

October 11, 2017

PHILADELPHIA--African American women were found to be twice as likely to be diagnosed with peripartum cardiomyopathy as compared to women of Caucasian, Hispanic/Latina, Asian, and other ethnic backgrounds, according to a new study--the largest of its kind--published today in JAMA Cardiology by researchers from the Perelman school of Medicine at the University of Pennsylvania. Peripartum cardiomyopathy (PPCM), a form of heart failure that occurs in the last month of pregnancy or up to five months following delivery, can be life-threatening. The new study is the first to pinpoint racial disparities associated with severity and effects of the condition.

"Not only are African American women at twice the risk, but in this study we found they also took twice as long to recover, they were twice as likely to worsen before getting better after diagnosis, and they were twice as likely to fail to recover altogether, meaning their heart failure persisted for months following delivery," said senior author Zoltan Arany, MD, PhD, an associate professor of Cardiovascular Medicine and director of the Cardiovascular Metabolism Program.

In this retrospective study, researchers evaluated the electronic medical records of 220 patients who had been diagnosed with PPCM or heart failure between January 1986 and December 2016 at the Hospital of the University of Pennsylvania, Pennsylvania Hospital and Penn Presbyterian Medical Center. The team analyzed patient demographics such as age and ethnicity, in addition to the patient's ejection fraction (EF)--the measurement of the percentage of blood leaving the heart each time it contracts--and whether the patient delivered twins, or had a cesarean delivery.

Researchers determined that African American women presented with symptoms of PPCM at a younger age--the average age was 27 years old--than non-African American patients, who averaged 31 years old at the time of diagnosis. African American patients also presented with a lower EF, and they continued to have a lower EF as compared to non-African American patients even after follow-up. A greater portion of African-American women also had worsening EF even after they began treatment, which caused to them take longer to recover than the others.

"While we know that African American women are at greater risk for PPMC, the disparity in disease diversity at presentation and the subsequent progression of the condition in this patient population was staggering," said the study's lead author, Olga Corazon Irizarry MD, a first year Obstetrics and Gynecology resident.

Another interesting finding from this study was the correlation between twin pregnancies, cesarean delivery, gestational hypertension and a PPCM diagnosis. African American women were found to be less likely to have twin pregnancies and to delivery via cesarean than their non-African American counterparts. But, African American women were more likely to experience chronic hypertension, which could be a risk indicator of PPCM.

"Our study, while a retrospective one, opens the door for even more research on this subject, to find out why these women are more at risk," said Jennifer Lewey, MD, MPH, an assistant professor of Cardiovascular Medicine and director of the Penn Women's Cardiovascular Center. "Is this risk increased due to genetics, socioeconomic status and access to care, or due to contributing medical problems such as hypertension? Our next step will be to answer these questions, and identify how we can proactively diagnose and potentially prevent such a dangerous diagnosis in this at-risk patient population."
-end-
Additional Penn authors on this study include Lisa Levine, Theresa Boyer, Valerie Riis, and Michal Elovitz. This study was supported by funding from the Edna G. Kynett Memorial Foundation and the National Institutes of Health (K12-HDOO1265-15, HL094499, HL126797).

Penn Medicine is one of the world's leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania (founded in 1765 as the nation's first medical school) and the University of Pennsylvania Health System, which together form a $6.7 billion enterprise.

The Perelman School of Medicine has been ranked among the top five medical schools in the United States for the past 20 years, according to U.S. News & World Report's survey of research-oriented medical schools. The School is consistently among the nation's top recipients of funding from the National Institutes of Health, with $392 million awarded in the 2016 fiscal year.

The University of Pennsylvania Health System's patient care facilities include: The Hospital of the University of Pennsylvania and Penn Presbyterian Medical Center -- which are recognized as one of the nation's top "Honor Roll" hospitals by U.S. News & World Report -- Chester County Hospital; Lancaster General Health; Penn Wissahickon Hospice; and Pennsylvania Hospital -- the nation's first hospital, founded in 1751. Additional affiliated inpatient care facilities and services throughout the Philadelphia region include Good Shepherd Penn Partners, a partnership between Good Shepherd Rehabilitation Network and Penn Medicine.

Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In fiscal year 2016, Penn Medicine provided $393 million to benefit our community.

University of Pennsylvania School of Medicine

Related Heart Failure Articles:

Transcendental Meditation prevents abnormal enlargement of the heart, reduces chronic heart failure
A randomized controlled study recently published in the Hypertension issue of Ethnicity & Disease found the Transcendental Meditation (TM) technique helps prevent abnormal enlargement of the heart compared to health education (HE) controls.
Beta blocker use identified as hospitalization risk factor in 'stiff heart' heart failure
A new study links the use of beta-blockers to heart failure hospitalizations among those with the common 'stiff heart' heart failure subtype.
Type 2 diabetes may affect heart structure and increase complications and death among heart failure patients of Asian ethnicity
The combination of heart failure and Type 2 diabetes can lead to structural changes in the heart, poorer quality of life and increased risk of death, according to a multi-country study in Asia.
Preventive drug therapy may increase right-sided heart failure risk in patients who receive heart devices
Patients treated preemptively with drugs to reduce the risk of right-sided heart failure after heart device implantation may experience the opposite effect and develop heart failure and post-operative bleeding more often than patients not receiving the drugs.
How the enzyme lipoxygenase drives heart failure after heart attacks
Heart failure after a heart attack is a global epidemic leading to heart failure pathology.
Novel heart pump shows superior outcomes in advanced heart failure
Severely ill patients with advanced heart failure who received a novel heart pump -- the HeartMate 3 left ventricular assist device (LVAD) -- suffered significantly fewer strokes, pump-related blood clots and bleeding episodes after two years, compared with similar patients who received an older, more established pump, according to research presented at the American College of Cardiology's 68th Annual Scientific Session.
NSAID impairs immune response in heart failure, worsens heart and kidney damage
Non-steroidal anti-inflammatory drugs, or NSAIDs, are widely known as pain-killers and can relieve pain and inflammation.
Heart cell defect identified as possible cause of heart failure in pregnancy
A new Tel Aviv University study reveals that one of the possible primary causes of heart failure in pregnant women is a functional heart cell defect.
In heart failure, a stronger heart could spell worse symptoms
Patients with stronger-pumping hearts have as many physical and cognitive impairments as those with weaker hearts, suggesting the need for better treatment.
Patients with common heart failure more likely to have lethal heart rhythms
New Smidt Heart Institute Research shows that patients with Heart Failure with Preserved Ejection Fraction (HFpEF) are more likely to have lethal heart rhythms.
More Heart Failure News and Heart Failure Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Teaching For Better Humans 2.0
More than test scores or good grades–what do kids need for the future? This hour, TED speakers explore how to help children grow into better humans, both during and after this time of crisis. Guests include educators Richard Culatta and Liz Kleinrock, psychologist Thomas Curran, and writer Jacqueline Woodson.
Now Playing: Science for the People

#556 The Power of Friendship
It's 2020 and times are tough. Maybe some of us are learning about social distancing the hard way. Maybe we just are all a little anxious. No matter what, we could probably use a friend. But what is a friend, exactly? And why do we need them so much? This week host Bethany Brookshire speaks with Lydia Denworth, author of the new book "Friendship: The Evolution, Biology, and Extraordinary Power of Life's Fundamental Bond". This episode is hosted by Bethany Brookshire, science writer from Science News.
Now Playing: Radiolab

Dispatch 3: Shared Immunity
More than a million people have caught Covid-19, and tens of thousands have died. But thousands more have survived and recovered. A week or so ago (aka, what feels like ten years in corona time) producer Molly Webster learned that many of those survivors possess a kind of superpower: antibodies trained to fight the virus. Not only that, they might be able to pass this power on to the people who are sick with corona, and still in the fight. Today we have the story of an experimental treatment that's popping up all over the country: convalescent plasma transfusion, a century-old procedure that some say may become one of our best weapons against this devastating, new disease.   If you have recovered from Covid-19 and want to donate plasma, national and local donation registries are gearing up to collect blood.  To sign up with the American Red Cross, a national organization that works in local communities, head here.  To find out more about the The National COVID-19 Convalescent Plasma Project, which we spoke about in our episode, including information on clinical trials or plasma donation projects in your community, go here.  And if you are in the greater New York City area, and want to donate convalescent plasma, head over to the New York Blood Center to sign up. Or, register with specific NYC hospitals here.   If you are sick with Covid-19, and are interested in participating in a clinical trial, or are looking for a plasma donor match, check in with your local hospital, university, or blood center for more; you can also find more information on trials at The National COVID-19 Convalescent Plasma Project. And lastly, Tatiana Prowell's tweet that tipped us off is here. This episode was reported by Molly Webster and produced by Pat Walters. Special thanks to Drs. Evan Bloch and Tim Byun, as well as the Albert Einstein College of Medicine.  Support Radiolab today at Radiolab.org/donate.