Video Interview with Dr. Keith Ferdinand on Atrial Fibrillation Among Blacks and African Americans

By Mellanie True Hills

March 22, 2011

  • Summary: This video explores the conundrum of why blacks appear to have less afib than whites, and what blacks should do if they have atrial fibrillation risk factors
  • Reading and listening time is approximately 5-6 minutes

In this video interview, Dr. Keith Ferdinand, Professor at Emory University and Chief Science Officer of the Association of Black Cardiologists, talked about minority health. He focused especially on heart disease and atrial fibrillation among blacks and African Americans. He addressed the conundrum of why blacks appear to have less afib than whites, and what blacks should be doing to prevent AF and heart disease.

He also talked about how drug research trials need enough different populations so that we can know if those drugs work as well in those different populations as in whites.

He concluded with a recommendation:

“If you are black or African American, you have hypertension [high blood pressure], obesity, or diabetes, [then] you have a risk for atrial fibrillation. If you feel palpitations, don’t let anyone tell you blacks don’t get atrial fib—anyone can get atrial fib. And if you get atrial fib, you need to treat it.”

That’s sound advice.

View the video with Dr. Ferdinand (just over 4 minutes)

About Keith C. Ferdinand, MD:

Clinical Professor, Cardiology Division, Emory University
Chief Science Officer, Association of Black Cardiologists

Keith C. Ferdinand, MD, FACC, FAHA, is a Clinical Professor in the cardiology division at Emory University, an Adjunct Clinical Professor at the Morehouse School of Medicine, and Chief Science Officer of the Association of Black Cardiologists (ABC).

Dr. Ferdinand is a clinical cardiologist and was previously the Medical Director at Heartbeats Life Center and professor of clinical pharmacology at Xavier University in New Orleans, Louisiana.

He was a member of the Ad Hoc Committee on Minority Populations for the National Heart, Lung, and Blood Institute (NHLBI), the National High Blood Pressure Education Program Coordinating Committee, and the Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) Data Safety and Monitoring Board and chair of Section Four of the Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 6). Additionally, he was director of the NHLBI Physician’s Health Network, a program that educated physicians and the lay population on cardiovascular risk reduction.

Dr Ferdinand received his medical degree from Howard University College of Medicine. He is board certified in internal medicine and cardiovascular disease, a diplomat certified in the subspecialty of nuclear cardiology, a certified specialist in clinical hypertension in the American Society of Hypertension, and a Fellow of the American College of Cardiology, American Heart Association, the National Lipid Association and the American Society of Hypertension.

See a detailed profile of Dr. Ferdinand.

Video Transcript:

This is Mellanie True Hills with I have with me today Dr. Keith C. Ferdinand. He is a clinical professor in the cardiology division at Emory University and also the Chief Science Officer of the Association of Black Cardiologists.

Dr. Ferdinand, thank you so much for joining us today. I’m honored that you are willing to share with us about the whole area of health disparities with afib, the whole area of minority health when it comes to afib. So let me just toss it to you to share with us.

Well first of all, we know specifically certain racial and ethnic minorities, specifically African Americans, have high rates of heart disease and high rates of the risk factors that lead to heart disease, and that includes hypertension, diabetes, obesity, physical inactivity. Now, here’s the conundrum, which is the perplexing finding. When you look at some of the data on atrial fibrillation, it appears that blacks have less atrial fibrillation than whites, in some data basis. So that’s the question.

And so what do we think is happening there? I’ve heard conjectures, there was discussion at HRS that perhaps blacks with hypertension were dying sooner and not really getting to the age of having atrial fibrillation.

I think that’s one of the big factors. Remember I said that blacks have more heart disease. Heart disease is the leading cause of death in the United States, so that when you look at heart disease mortality death rates for black men, it’s the highest, for black women, it’s next highest. In fact the black death rates for black women is similar to the death rates for white men, such that being a black female loses the protective affect of being female. So now if you have a cause of death which is overwhelming, if you have decreased life expectancy one of the most powerful predictors of the increase in atrial fibrillation that we see is the age, so less people in the black community are reaching a certain age, you have what’s called competing conditions. You have heart disease early in life, less atrial fibrillation identified perhaps that’s the sad thing people are dying of.

What is it that blacks should be doing in order to prevent heart disease and of course atrial fibrillation as well?

I think atrial fibrillation is an equal opportunity killer. For a person who has atrial fibrillation, their risk of stroke is just as high as if they’re black, white, Hispanic, East Asian, doesn’t make a difference. Secondly, if you control risk factors, you’re controlling what causes the atrial fibrillation. So controlling blood pressure, controlling diabetes, controlling coronary disease is important for all populations.

The reason you look at some of this data, and you see things in big data sets, doesn’t translate to the individual. The individual has a responsibility to control his or her risk factors.

We know that there are some medications that have been found to not necessarily work well in whites but to work well in blacks, are you aware of any studies being done with atrial fibrillation drugs to determine disparities in different races?

No, at this particular point most of the drugs have been done in primarily white populations in terms of their studies to get approval, so some of the newer medicines probably work as well at a glance, but they may not have had a sizable proportion of blacks in the studies to give us confidence on that. So what we need to do in research is make sure we have a diverse population, we have enough people from various populations including research so that we know that drugs work equally across populations.

Here’s what I suggest: if you’re black or African American, you have hypertension, obesity, diabetes, you have a risk for atrial fibrillation. If you feel palpitations, don’t let anyone tell you blacks don’t get atrial fib – anyone can get atrial fib. And if you get atrial fib, you need to treat it.

Absolutely. Great advice. Thank you so much for joining us today.

It’s my pleasure. Thank you.