It’s not you, it’s your genes: the hidden cause of heart disease in black women

Imagine evolving in your health and wellness journey by specializing in a heart-healthy lifestyle through dietary adjustments, increased physical activity, and drinking your favorite glasses of wine in moderation. However, despite following suggested suggestions for optimal cardiovascular health, you discover that you just are still in danger for heart disease and the root cause lies in your DNA.

For black women especially, genes, or what runs in the family, have a major impact on our heart health. Amidst the plethora of discussions about maintaining a healthy heart, one key aspect has often been ignored of the conversation: lipoprotein(a), commonly often called Lp(a).

Lp(a) is a specialized type of lipoprotein that carries cholesterol in the blood and could be very different from other, more common forms.

“This particular type is genetic and increases the risk of heart disease regardless of diet and exercise,” says Keith C. Ferdinand, M.D., a cardiology specialist and professor of medicine at Tulane University School of Medicine. “And because it is genetic, it can put you at risk of premature or sudden heart disease or stroke.”

The complexities of Lp(a) add to an already complex discussion about the risk of heart disease in black women, who, based on the American Heart Association, are 60 percent more likely than white women to have hypertension – one of the leading causes of heart disease.

Research suggests that black and South Asian women are inclined to have higher average levels of Lp(a) in comparison with other ethnic groups, and although Ferdinand says there is no such thing as a specific research to grasp why these groups are most affected , it presents a Theoretical Perspective.

“There are certain genetic tendencies that may have been protective before modern times, but are now considered a disease,” he says. “Perhaps lipoprotein(a) has some protective factors that we cannot identify. Since it increases blood clotting and humans developed in sub-Saharan Africa, it may have been beneficial to have a substance that would speed up blood clotting following injury, a fall or childbirth.”

Nevertheless, it reminds us that this is barely a theory, as research on Lp(a) is restricted to the point that awareness amongst doctors and clinicians is comparatively recent.

“Traditionally, Lp(a) is not measured when checking cholesterol levels,” says Ferdinand. “But now that physicians are learning that it is a serious driver of heart disease, clinicians are increasingly recognizing the need to include Lp(a) testing in standard cardiovascular risk assessments.”

Because Lp(a) testing is not yet common, she underscores how essential it’s for Black women to advocate for themselves by asking to be tested during regular checkups — especially in the event that they have a family history of premature disease.

“Shared decision-making and conversations between the patient and the doctor can help identify risks and determine whether to be tested for Lp(a),” he says. “That’s why it’s important that you and your doctor know and understand your family history of heart disease.”

While it could actually be disheartening to understand that chances are you’ll still be liable to heart disease despite doing the “right thing,” all is not lost. There are some proactive measures you may take to enhance your overall heart health, not directly impacting your Lp(a) risk.

Ferdinand advises individuals who may imagine they’re predisposed to elevated Lp(a) levels to proceed to keep up a healthy weight, avoid smoking, select healthy foods and drinks, and interact in regular physical activity.

So this February, during American Heart Health Month, tackle more proactive cardiovascular health in a special way. Find out more about your family medical history and confer with your doctor about testing your Lp(a) levels. These measures can have a major impact on your heart health journey and should even be life-saving.