Birthplace Bigger Factor Than Race In Heart Disease

When it comes to death among blacks from heart attacks, birthplace could be more important than race, according to a new study that shows that blacks living in New York City who were born in the South are twice as likely to die of a heart attack than Northern-born blacks or whites.

The study also showed that Caribbean-born blacks living in New York City had much lower rates of death due to heart disease than either blacks or whites born in the United States. Researchers believe Caribbean natives may have a lower death rate because they started life on a healthier diet filled with fruits and vegetables and presumably less stress.

Up to now the higher rate of heart disease and heart-related mortality among blacks has been attributed to race and genetics, said Dr. Micheal Alderman, chairman of epidemiology and social medicine at the Albert Einstein College of Medicine in New York City and one of the study’s authors. Researchers reviewed death records of blacks from 1988 through 1992 and determined, for example, that the cardiovascular disease death rate among black men aged 25 to 44 who were born in the South was 30 percent higher than for Northeastern-born blacks and four times that of Caribbean blacks.

These data indicate, Alderman said, that environmental factors such as diet, psychological influences and cultural life could be the key to figuring out how to prevent cardiovascular disease. And it also shows that many of these influences could come into play early in life and stay with a person even after they migrate to another part of the country.

“If you’re looking for clues to what causes heart attacks or what prevents them from happening by just looking at blacks as a homogeneous group, you’re missing the point,” said Alderman. He added that while the numbers were statistically insignificant, the team did look at death rates among whites based on whether they were Northern- or Southern-born and saw the same pattern emerging.

“I think now we have to begin real population-based studies,” Alderman said.

If researchers can isolate what it is about Caribbean-born people’s early life that leads to their lower-than-average heart-related mortality rate, those findings could be applied to people in the United States, he added.

Several cardiology researchers and experts around the country Wednesday said the study was surprising and suggested it would open up new avenues of research into blacks and heart disease.