Dr Greg Hall

“PVD”- Peripheral Vascular Disease & African Americans

Posted on by Dr Greg Hall

“My Legs are Tired”

People who experience poor circulation often see changes in the color of the skin of their legs and encounter problems walking long distances. As one person described, “I have to sit down because my legs get tired.” After taking a brief break, the discomfort or fatigue subsides, and they are able to continue walking. Furthermore, some people report leg pain during sleep that is relieved by sitting on the edge of the bed or in a chair. This type of pain reflects extremely poor circulation because the force of gravity is assisting in the movement of blood toward the feet. If any of this sounds familiar, you need to see your doctor soon. Many times you may not know that your circulation is poor so screening by your doctor can help. Other times you may develop an ulcer or sore that is very slow to heal.

Circulation Problems are Worse in African Americans

Many studies have shown that there are significant differences in the treatment, management, and outcomes for patients with peripheral vascular disease (PVD) and limb ischemia (pain due to poor circulation), particularly when it comes to race. Specifically, African-American patients with peripheral vascular disease (PVD) are more likely to have amputations of limbs (usually their legs) and less likely to receive procedures designed to open their circulation, when compared to their Whites. These disparities highlight the urgent need to address physician biases and improve access to appropriate medical care for all patients, regardless of race or ethnicity.

More Amputations Because We Wait Too Long

In a study, it was found that African-Americans had a significantly higher risk of leg amputation compared to White patients. Researchers discovered that the difference was White patients sought treatment in the earlier stages of their peripheral vascular disease (PVD) but Black patients tended to seek care only when their condition had become severe. As a result, African Americans tended to have more advanced disease at the time of hospital admission, which was associated with worse a prognosis. The study suggests that the lack of access to doctors and medical care in Black communities was a major contributor to this disparity.

Please Stop Smoking

Smoking & Heart Disease

The Jackson Heart Study conducted research on African Americans and found that smoking cigarettes had a direct connection to peripheral vascular disease. In addition, the severity of the disease was also linked to the number of cigarettes smoked per day. The research also revealed that African Americans who smoke are at a higher risk for peripheral artery disease compared to Whites. Specifically, the risk was found to be twice as high for African Americans who smoke.

Lower Your Cholesterol

Here is an article on cholesterol medicine you should read.

The moral of the story is that it is important to quit smoking as early as possible and to maintain healthy cholesterol levels in order to prevent more serious illnesses related to your circulation. To reduce the buildup of plaque in your arteries, taking a medication such as a statin has been shown to be effective. Therefore, it is crucial to prioritize your health by making lifestyle changes and taking necessary medications to prevent the onset of advanced diseases.

Dr Greg Hall

Heart Disease & the Black Community

Posted on by Dr Greg Hall

African Americans have the worst heart and stroke outcomes of all. African Americans are at a higher risk than White Americans for heart diseases as evidenced by their:     

  • 2-fold increased risk for stroke
  • 4-fold increased death from stroke
  • 2.5-fold increased risk for heart failure
  • 1.5 fold increased risk for high blodd pressure
  • 1.7 fold increased risk for diabetes

Hypertension, or high blood pressure, is a serious health concern, particularly for African Americans in the United States. We have the highest amount of high blood pressure in the country and is among the highest in the world. Researchers have conducted numerous studies to identify why we have such horrible heart disease and they believe uncontrolled high blood pressure (hypertension) is the reason. High blood pressure has been linked to an increased risk of several serious health conditions, including heart attack, heart failure, stroke, and kidney disease.

Even Slightly Higher Blood Pressure is a Problem

It’s important to note that even a slight increase in blood pressure can significantly increase an individual’s risk of developing heart disease. For example, beginning with a blood pressure reading of 115/75, an individual’s risk doubles with every additional rise of 20/10. According to recent data, high blood pressure is present in almost half of Black men and women.

Along with age and family history, other commonly accepted risk factors for high blood pressure include being overweight (obesity), individual and neighborhood socioeconomic status, and various lifestyle factors such as activity level, diet, and smoking.

Some of Our Problem Is STRESS!

A study by Deborah Rohm Young and colleagues found that high blood pressure rates among African Americans did not vary significantly based on neighborhood socioeconomic status or progressive obesity, indicating the need for further research into the root causes of this health issue. This points to “oppression” as a driving force for increased heart disease in Blacks (both rich and poor, educated and uneducated) rather than poverty, lack of insurance, or poor education. This study provides compelling evidence that suggests a curious finding: even African Americans residing in rich suburbs with presumably higher income and greater access to healthier foods and exercise opportunities are unable to escape significantly increased high blood pressure risk.

Salt is Really Bad for You

The research on genetic differences in high blood pressure in African Americans is focused on identifying factors that may contribute to making our health worse. One such factor is the potential existence of a salt-sensitive gene, which has received a lot of attention. The scientists, Jackson Wright, MD and colleagues, conducted a study on salt sensitivity and found African Americans with worse salt-sensitive high blood pressure were prone to more heart disease. Watching your salt is a great first step to decreasing blood pressure and resulting heart disease.

Check Your Own Blood Pressure

Dr Greg Hall
Buy a blood pressure monitor and check your own blood pressure. They are very affordable.

Regularly monitoring your blood pressure using a home blood pressure monitor can be an excellent approach to guarantee that your blood pressure medication is effectively reducing your blood pressure. By keeping your blood pressure below 120/80, you can significantly decrease your risk of developing various health complications associated with high blood pressure. Therefore, it is crucial to measure your blood pressure regularly and keep track of your readings to ensure that your risk for heart attack or stroke is at its lowest.

Dr Greg Hall

Magnesium Deficiency and African American Health

Posted on by Dr Greg Hall

9 out of 10 Older Black Adults Have Low Magnesium

Minerals like magnesium are vital to maintaining good health, and magnesium specifically plays a key role in controlling diabetes and promoting healthy blood vessels. Unfortunately, many people are not aware of the importance of minerals in their diet. Every organ in the body, especially the heart, muscles, and kidneys, needs magnesium to function at its best. Magnesium also contributes to the makeup of teeth and bones. Magnesium activates enzymes, contributes to energy production, and helps regulate levels of calcium, copper, zinc, potassium, vitamin D, and other important nutrients in the body. In short, a good magnesium level is essential for good health, but 9 out of 10 of older Black Americans have low magnesium levels.

Magnesium Deficiency Leads to Diabetes, Heart, and Kidney Problems

Magnesium deficiency can lead to diabetes. Take a look at this article to learn more about diabetes differences in African Americans.

Studies have found that African Americans are at a higher risk for diabetes, high blood pressure, heart disease, and kidney problems, and a lack of magnesium in their diet can worsen these conditions. In fact, due to their increased risk, African Americans require more magnesium than other groups, and a deficiency in this mineral can contribute to poor diabetes control. Additionally, many of the health conditions associated with magnesium deficiency occur more frequently among African Americans. For example, diabetes is up to three times more common in people of African or Afro-Caribbean origin, and they are also at a greater risk for hypertension, osteoporosis and fractures, and frailty. Given this, addressing racial inequalities in vitamin and mineral deficiencies should be a health priority, and magnesium supplementation in African Americans at risk of deficiency could help reduce established health disparities.

Poor Energy Too?

In addition to its role in controlling diabetes and promoting healthy blood vessels, magnesium is also important for muscle function, energy production, and healthy aging. A deficiency in magnesium can lead to problems such as memory loss, weak muscles, and even broken bones. To prevent these health issues, it is recommended to include magnesium-rich foods or supplements in your diet. For example, taking GNetX Sequence Multivitamins for African Americans, which has added magnesium, might help control diabetes, keep blood vessels healthy, and reduce the risk of heart attacks, kidney problems, and strokes.

But PLEASE don’t stop taking your prescribed medication for diabetes or high blood pressure because you started a multivitamin . . . you still need your medicine too. Multivitamins are a way to improve your daily nutrition intake and optimize your health, not correct or cure a disease.

GNetX Sequence Multivitamins for African Americans has added magnesium and potassium.
High Creatine Kinase in Blacks

Elevated “CK” or Creatine Kinase Level?  In African Americans, This May NOT be a Problem

Posted on by Dr Greg Hall

Creatine kinase (CK) is a chemical/enzyme that exists in human muscle cells, heart cells, and also small amounts can be found in brain cells. Body cells can release creatine kinase (CK) into your bloodstream when they’re damaged or related to normal cell recycling. Many Black men have been told by their doctors they have a substantially “elevated CK level.”   Most are perplexed by the high readings and unfortunately, many medical providers are at a loss when asked to explain the problem. 

What many medical providers don’t know is African Americans tend to have significantly higher baseline CK levels. Essentially, Black Americans can have dramatically higher CK blood levels with Black men having the highest levels.

Research Confirmed: Higher CK in Blacks

A large study done at Vanderbilt University revealed consistently higher CK levels in African Americans with substantially even higher levels in Black men.  Because CK is generally released from the muscle, many believed that the increased muscle mass seen in African American men explained the difference, but after further analysis, the muscle mass explanation didn’t explain the significant difference. 

Normally when you see elevated creatine kinase (CK) levels in the blood, it can be associated with strenuous exercise, excessive alcohol use, some medications, toxins/poisons, and particularly after a heart attack. CK levels are frequently drawn on patients when they go to the emergency department with chest pain presumed to be heart-related.  An elevated CK level in these situations can suggest heart muscle damage that can lead to a heart attack.

Some have seen the CK level be elevated in people taking statin medications. Others find that the elevated CK levels were associated with undiagnosed rheumatologic disorders (called idiopathic inflammatory myopathy).

Higher CK Normal Range in Black Men & Women

The important message is the significantly higher “normal range” for both African American men and women. The table below from research at the University of Pittsburg suggests these different parameters.  Essentially, if an African American man has no muscle aches and pains and a normal physical exam, their CK level can be as high as 1200 IU/L, which is twice as high as a White man.

Higher CK in Blacks
Moghadam-Kia S, Oddis CV, Aggarwal R. Approach to asymptomatic creatine kinase elevation. Cleve Clin J Med. 2016 Jan;83(1):37-42

In all humans, the creatinine kinase (CK) levels decrease with age and this decrease is likely related to loss of muscle mass consistent with aging.

The graph below shows the dramatically different range and distribution of CK levels by race/ethnicity with Black men and women being substantially higher than all other groups.

Higher CK in Blacks
George, Michael D. MDa,*; McGill, Neilia-Kay MDa; Baker, Joshua F. MD, MSCEa,b,c. Creatine kinase in the U.S. population: Impact of demographics, comorbidities, and body composition on the normal range. Medicine: August 2016 – Volume 95 – Issue 33 – p e4344 doi: 10.1097/MD.0000000000004344

The authors reported the following:

“The most notable factor that contributed to higher CK levels was Black race. Previous studies suggested that racial differences in CK may not be due to differences in height, weight, or body mass, but did not evaluate other body composition measures. This study evaluating BMI, waist circumference, and arm circumference, provides additional evidence that racial differences are not explained by differences in muscle mass. Higher CK levels among black individuals might instead be due to differential production or clearance of CK.”

George, Michael D. MDa,*; McGill, Neilia-Kay MDa; Baker, Joshua F. MD, MSCEa,b,c. Creatine kinase in the U.S. population: Impact of demographics, comorbidities, and body composition on the normal range. Medicine: August 2016 – Volume 95 – Issue 33 – p e4344 doi: 10.1097/MD.0000000000004344

High Creatine Kinase in Blacks

Essentially the authors suggest a fundamental difference in either the production of creatinine kinase or its destruction in African Americans . . . and the difference is significant!

The differences in creatinine kinase levels in African Americans have been known for over 40 years, but adjustments in the “normal range” used by laboratories have not been implemented.   When these so called lab “abnormalities” are seen, medical providers begin a range of investigations as well as suggest interventions to patients that imply that something is wrong or abnormal when in reality they simply seeing a normal variant.

Appropriate knowledge of these important differences in the care of African Americans can lead to improved care and much less worry on the part of the patient and provider.

African Americans Need to Walk More! More Daily Steps Tied to Better Overall Health

Posted on by Dr Greg Hall

Regular exercise has always been associated with better health. Still, with newer smartphones, watches, and “wearables,” we can now measure more accurately how much walking and exercise we get in a day. Unfortunately, we in the Black community do not get near enough exercise or even simple walking.

A study done at Rutgers University showed that the percentage of Blacks achieving physical activity guidelines was low and continued to decrease further with age. The highest amount of exercise was seen in the youngest in our community and started to decrease steadily from age 15 to age 65 and beyond.

Single Black Men Exercise the Most

Black men of all ages exercised significantly more than Black women. The researchers attributed this difference in gender to several factors, including neighborhood safety, child-rearing responsibilities, concerns about personal appearance, and other cultural dynamics.  

Black men that were “never married” exercised more than “married men.” In contrast, women who were “married/living with a partner” exercised more than “never married” and “no longer married” women. Go figure that out!

Employment is Good for Your Health

Unsurprisingly, “employed” people were more physically active across all demographics. Arising in the morning with a purpose and the activities inherent in being employed is good for your health. Walking is a big part of being employed with steps being counted associated with parking, job duties, breaks, socialization, and more while at work.

Education & Money is Good for Your Health

Also not surprising was the data that showed higher education and income are associated with more exercise and better health.

Increasing Your Daily Steps is a Great Start!

A study published this week showed that getting 9800 steps in a day was associated with a dramatically lower risk for dementia and getting as low as 3800 steps still showed a 25% reduction in risk. Most smartphones have a “steps counter” that is free and already measuring your steps (whether you know it or not). Take a look and see where you stand (or step).

Let’s Get Started!

It’s time to start benefiting from health research and incorporating more exercise in the form of walking into our daily routine. Married men need to get off of the couch and represent! Black women of all ages and social engagement need to know that their mental and physical health depends on their activity level . . . and there should be no excuses.

Low Potassium and African Americans

Posted on by Dr Greg Hall

Potassium doesn’t get enough credit as a very beneficial nutrient to good health and potassium deficiency (low potassium) has been directly related to high blood pressure, heart problems, diabetes, muscle weakness, fatigue and much more.

Multiple studies have confirmed that African Americans are much more likely to lack potassium and low potassium can be linked to higher blood pressures, diabetes and a number of other health problems that impact the Black community.

As much as high sodium (“salt”) can be a problem, low potassium can also be a problem . . . a big problem. Potassium is an essential mineral that has many functions in your body. For example, it is central to muscle contraction, it maintains healthy nerve function, and regulates water balance in your body. With all of those essential functions, it is a wonder that so many people, including African Americans are low in potassium. 

Curiously, low potassium has also been linked as a diabetes risk in African Americans. A large study at John Hopkins found that African Americans with lower potassium levels had a higher risk for diabetes.  The author said “”we now know lower serum potassium is an independent risk factor for diabetes and that African-Americans have, on average, lower potassium levels than whites.” 

Previous studies have also found that lower potassium was directly linked to higher blood sugar levels. The higher the blood sugar, the higher the risk for diabetes . . . and high blood pressure. Yet another study found that taking a potassium supplement directly lowered the blood pressure of Black patients. Lowering your blood pressure reduces your risk of heart disease and stroke.

The CDC says that increasing your potassium intake can reduce your risk of heart disease and stroke by lowering blood pressure. Conversely, consuming too little potassium (and too much sodium) can increase your risk of heart disease and stroke.

Foods that are rich in potassium include beans, leafy green vegetables (greens, spinach, etc.), potatoes, sweet potatoes, yams, squash, beets, broccoli, and bananas.

Low Potassium, African Americans

It is important to note that salt-substitutes are generally swapping potassium for sodium so using them in moderation can also be a benefit.

Always check with your doctor before changing your potassium intake because people with kidney problems, heart problems, or take certain medications may make things worse if their body has trouble processing the increased potassium. People on dialysis or have poor kidney function, for example, have to be vigilant about not getting too much potassium (as well as protein and sodium), and are frequent prescribed a low potassium diet.

GNetX Sequence Multivitamins for African Americans were formulated to replace science-confirmed vitamin and mineral deficiencies seen in our community . . . AND has added POTASSIUM.

Stroke & Nutrition

Vitamin D Deficiency is Associated with Stroke Risk in African Americans

Posted on by Dr Greg Hall

Recent studies have found a correlation between vitamin D deficiency and stroke risk as well as stroke severity. A study just published found that people with the highest vitamin D levels had fewer strokes and if they had a stroke, it was less severe.  People with low vitamin D levels had more strokes with more severe symptoms. 

As you know, we get most of our vitamin D from the sun, but urban living, colder/cloudy weather, and lactose intolerance (so we can’t drink “Vitamin D Milk”) have all resulted in wide-spread African American vitamin D deficiency.

African Americans Have Low Vitamin D Levels

Four of five African Americans have low levels of vitamin D, and we also have the highest rates of heart attack, stroke, and circulation problems. Risk factors for low vitamin D levels include older age, darker complexion, obesity, and limited sun exposure.

Studies have shown that hemorrhagic stroke patients (those strokes caused by a bleed rather than a blood clot) often suffer from low vitamin D levels. Another study suggested that putting stroke victims on vitamin D helped their recovery somewhat.

Biologically, vitamin D reduces total cholesterol and fat in blood as well as improves inflammation which helps your blood vessels stay healthy.

A Direct Effect Has Not Been Shown

To be clear, there has yet to be a study that showed taking a vitamin D supplement led to fewer strokes. These research studies are only able to find correlations and from these associations, they “suppose” that raising your vitamin D level will lead to better health.  Some researchers believe that poor health leads to low vitamin D levels and that is the reason sicker people have low vitamin D. 

Vitamin D levels have been positively associated with improved cardiovascular health, especially with reduction of stroke risk. Until the controversy is settled, everyone agrees that leaving a low vitamin D alone is not a reasonable option. 

Vitamin D is best increased through natural means . . .  sun exposure, a healthy diet, etc. Foods high in vitamin D include salmon, herring/sardines, cod liver oil, tuna, mushrooms, and fortified beverages (milk, orange juice, and cereal).

Good Vitamin D Levels Help in COVID Patients

Another study looked at COVID patients and vitamin D deficiency and found COVD illness directly related to vitamin D level.  COVID-19 is greatly associated with increased stroke and heart attacks so having a normal vitamin D level was somewhat protective against severe COVID disease.  Obviously the absolute best way to avoid COVID-19 is through getting an approved vaccination.

GNetX Sequence Multivitamins for African Americans have a science-based formula to best replace deficiencies in the Black community. Go to SequenceMultivitamins.com for more information on the multivitamin that is best for you.

https://vimeo.com/750344190

About Dr Greg Hall

Greg Hall, MD is a physician, author, speaker, inventor, professor, and public health professional, specializing in urban health and the clinical care of African Americans. Dr. Hall’s extensive research in the care of African Americans lead to the development of GNetX Sequence Multivitamins a supplement developed to support African American needs. Most recently, Dr. Hall established the National Institute for African American Health, which is a nonprofit designed to promote health-related education, support students interested in a career in medicine, and serve as an advocate for African American patients. You can keep in touch with Dr. Hall by tuning into his Better Black Health Podcast where he covers Black American health topics.

Diabetes Differences in African Americans

Posted on by Dr Greg Hall2 Comments

Diabetes Differences in African Americans

There has been some startling discoveries lately in the differences in how diabetes is diagnosed and treated in African Americans. Because of genetic nuances that we normally may ignore as insignificant, hundreds of thousands of African Americans remain  under-diagnosed and under-treated for diabetes.

Diabetes already occurs at an unusually high rate in African Americans and we are 80 percent more likely to be diagnosed than White Americans.  Of those with diabetes, there is a higher tendency for organ damage (heart disease, kidney failure, or blindness, for example) than Whites.  The prevalence of visual problems, kidney problems, leg amputations, and overall hospitalizations are dramatically higher in African Americans with diabetes.

The CDC reports that African American men die at over twice the rate of any other race or gender group from diabetes. It was also found that these differences were not solely due to the African American diet, genetic differences played a part as well.

Diabetes is diagnosed at an earlier age (median age 49 vs. 55.4 in White Americans) and this earlier age is significant because the development of diabetes complications is directly related to both blood sugar control as well as the total time a person has the disease.  By getting diabetes earlier, there is more time to get complications.  Make sense??

Diabetes Differences in African AmericansMost research dealing with the increased diabetes in African Americans points to increased insulin resistance when compared to White Americans. This means your body has insulin but is “resistant” to its normal function.

A recent study of over five thousand African Americans curiously showed that heavy smoking (more than a pack of cigarettes a day) significantly increased their risk for diabetes by worsening the insulin resistance.  Former smokers and people who never smoked had a much lower risk for diabetes compared to the heavy smokers.

HbA1c (Hemoglobin-A-One-See), the blood test used to diagnose and track diabetes, is generally a point higher in African Americans (8.9 in White Americans and 9.8 in African Americans), and when controlling for socioeconomic status, quality of care, self-management behaviors, and access, African Americans still have higher HbA1c levels.

Another study by Saaddine and colleagues looked at younger patients age 5 to 24 years and found that African American youths consistently had higher HbA1c levels even without diabetes.

HbA1c is Different in African Americans

In all, HbA1c value differences in African Americans essentially equates to a 0.4% difference (higher) for glucose matched White American patients.  So a HbA1c of 7.0, the normal threshold to diagnose diabetes, is really 7.4 in African Americans.  Diabetes should have been diagnosed when the HbA1c was 6.6.   Put simply, the accepted relationship between HbA1c and the coinciding blood glucose used by doctors and laboratories is different for African Americans.

“The relationship between mean blood glucose and HbA1c may not be the same in all people. Indeed, the published regression line from the “A1c-Derived Average Glucose” (ADAG) Study demonstrated a wide range of average glucose levels for individuals with the same HbA1c levels.” 

Diabetes Differences in African Americans

If these facts aren’t confusing enough, another study found the HbA1c levels are “less dependable” when they are “near normal” in African Americans.  High and low HbA1c levels tend to be much more accurate when estimating the average blood sugars.

Because of the limitations of HbA1c measurements in some situations and the racial differences discussed above, some of the patients with a HbA1c level between 5.5% and 7% will clearly have diabetes, and others will not.

Another curiosity with HbA1c has to do with patients with a sickle cell trait:

“Among African Americans from 2 large, well-established (studies), participants with sickle cell trait had lower levels of HbA1c at any given concentration of fasting compared with participants without sickle cell trait. These findings suggest that HbA1c may systematically underestimate past glycemia in (African American) patients with sickle cell trait and may require further evaluation.” 

Given that one in ten African Americans have sickle cell trait, it is important to consider their trait when interpreting the results of a HbA1c.  In the end, people with sickle cell trait can be tricky to diagnose diabetes.  Many doctors neglect to ask if someone has sickle cell trait because, outside of genetic counseling before having children, there has conventionally been little impact on other disorders.  Is your doctor aware of this genetically-based difference?

More Genetic Differences . . .

A recent study of over 160,00 patients looked at specific genes and how they impacted the diagnosis of diabetes. One in particular, the G6PD gene variant, was found to significantly impact the results of HbA1c tests in African Americans. This specific gene variant is almost totally unique to people of African ancestry.  In fact, about 11 per cent of African Americans carry this gene variant.

“The issue with the G6PD genetic variant is it artificially lowers the value of blood sugar in the HbA1c test, and can lead to under-diagnosis of people with type 2 diabetes. We estimate that if we tested all Americans for diabetes using the HbA1c test, we would miss type 2 diabetes in around 650,000 African Americans.”

Between the 10% of African Americans with sickle cell trait and the 10% with the G6PD gene variant trait, a huge number of African Americans with diabetes are being un-diagnosed or diagnosed late with advanced diabetes.   Diagnosing diabetes as soon as it strikes, gives everyone (the doctor and patient) adequate time to prevent complications before they occur.

If you have just been diagnosed with diabetes, I have a great video that will get you off to a good start below.

If you want to know about other genetic differences look HERE.

About Dr Greg Hall

Greg Hall, MD is a physician, author, speaker, inventor, professor, and public health professional, specializing in urban health and the clinical care of African Americans. Dr. Hall’s extensive research in the care of African Americans lead to the development of GNetX Sequence Multivitamins a supplement developed to support African American needs. Most recently, Dr. Hall established the National Institute for African American Health, which is a nonprofit designed to promote health-related education, support students interested in a career in medicine, and serve as an advocate for African American patients. You can keep in touch with Dr. Hall by tuning into his Better Black Health Podcast where he covers Black American health topics.

More Sleep Apnea in African Americans

Posted on by Dr Greg Hall1 Comment

Sleep Apnea is more common in African Americans

More Sleep Apnea in African AmericansA recent study confirmed there is more sleep apnea in African Americans than in Whites. Sleep apnea (also call Obstructive Sleep Apnea / “OSA”) is a condition where people repeatedly stop breathing while they sleep.  The outcome is a very poor sleep cycle and interrupted sleep.  The lost sleep leads to daytime sleepiness, fatigue, poor concentration, poor energy, increased high blood pressure, heart disease, poor digestion and metabolism, and more.

Scientists found significantly increased sleep apnea patterns, more snoring, more obesity, and poor global functioning in African Americans.  The same study also showed decreased formally diagnosed sleep apnea in African Americans despite the disproportional increased occurrence. Doctors are not asking about poor sleep and snoring, and therefore not diagnosing it.

Sleep apnea can be the cause in 40% to 80% of people with hypertension, heart failure, heart disease, pulmonary hypertension, atrial fibrillation, and stroke.  That’s because untreated sleep apnea causes high blood pressure and a huge strain on your heart.  That strain can cause strokes, failure, or heart beat irregularities (arrythmias) that can result in death while you sleep.

African Americans have a poorer sleep quality overall associated with worse insomnia levels and the highest levels for excessive daytime sleepiness. That increased fatigue and sleepiness can cause difficulty at work, trouble watching movies without falling asleep, difficulty with drowsiness while driving, and so on.

But CPAP fixes this!

Continuous Positive Airway Pressure CPAP therapy reduces daytime sleepiness, improves depression and quality of life, and reduces deaths.  Overall only about half of people with sleep apnea and a CPAP machine use it.  But in African Americans the use of this life-saving treatment is even worse.  Black Americans were over 5 times more likely to not use their CPAP machine than White Americans.

Because modern CPAP machines can monitor (and transmit data) about usage and sleep efficiency, researchers were able to determine that African Americans that used the CPAP machine still averaged one hour less of nightly sleep.

Blacks with Sleep apnea

Like many health problems, African Americans show significant improvement in CPAP usage when they understand how it works . . . and why it works.  A large study found that only about a quarter (26%) of African Americans were using their CPAP machine at 2 weeks compared to almost half  (47%) of Whites.  They also found that adjusting for income, demographics, and other diseases had no impact on its use.

The finding that African Americans with more severe sleep apnea were 3 times more likely to use CPAP than those with mild or moderate sleep apnea possibly is due to subjectively perceived effectiveness.  In focus groups, African American patients said that even with the inconveniences of CPAP, they would use the device if they thought of it as helpful.  

The study also failed to show a correlation between socioeconomic status in African Americans and CPAP usage . . . there was no difference between wealthier and more educated African Americans and poorer less educated African Americas in terms of who took advantage of the benefits of the CPAP machine.  All were poor.

What makes African Americans avoid CPAP therapy?

The only thing that increased use of CPAP therapy in African Americans was having more severe sleep apnea.  The more severe the episodes of not breathing, the higher the use of the CPAP machine.  In mild and moderate sleep apnea, the patients may not trust their doctor enough to take their advice . . . this could explain the disparity.

I find that my patients prefer a Tap Pap CPAP mask that only goes into the nostrils and is held in place by your upper teeth.

Sleep Apnea in African Americans

This “mask” allows more sleeping on your side and is far more comfortable.  Wearing the CPAP at night and getting a restful nights’ sleep is essential for health.  People are shocked to hear that their heart is enlarged and may be barely functioning, or that their blood pressure is high, all due to poor sleep . . . and the simple use of CPAP therapy can potentially reverse it!

Don’t take a good night’s sleep for granted, it can literally shorten your life.  And ask your sleeping partner about snoring and gaps in breathing.  You could easily have sleep apnea.  Then make a point of mentioning it to your doctor because sleep apnea is frequently missed.

About Dr Greg Hall

Greg Hall, MD is a physician, author, speaker, inventor, professor, and public health professional, specializing in urban health and the clinical care of African Americans. Dr. Hall’s extensive research in the care of African Americans lead to the development of GNetX Sequence Multivitamins a supplement developed to support African American needs. Most recently, Dr. Hall established the National Institute for African American Health, which is a nonprofit designed to promote health-related education, support students interested in a career in medicine, and serve as an advocate for African American patients. You can keep in touch with Dr. Hall by tuning into his Better Black Health Podcast where he covers Black American health topics.

Heavy Smokers at Higher Risk for Diabetes

Posted on by Dr Greg Hall

African American smokers have higher risk for diabetes

A large study consisting of over five thousand African Americans found that those African Americans who smoke more than a pack of cigarettes in a day were at increased risk for diabetes.  This ground-breaking news was published in the Journal of the American Heart Association.

The study group included current heavy smokers, former smokers, and “never” smokers, all of whom were African Americans, and followed them over the course of  several visits. At the end of the study, they looked to see who had developed diabetes. Both former and non-smokers had similar occurrences . . . which is good news for people who have stopped smoking.

African Americans who smoked more than a pack a day of cigarettes had a much higher occurrence of developing diabetes (up to 40 percent higher!!). The increased smoking was associated with “impaired pancreatic beta cell function.” The pancreas is where insulin is made and proper insulin secretion is how sugars are absorbed into the body.
The researchers go on to say:

“Although smoking cessation should be encouraged for everyone, certain high‐risk groups such as blacks who are disproportionately affected by diabetes mellitus should be targeted for cessation strategies.”

Are you at risk for diabetes?

Being over-weight and having a strong family history of diabetes puts many African Americans at increased risk for developing this disease. Now we can add heavy smoking to the list!
While African Americans have lower teenage smoking rates, they have high adult rates, longer smoking duration, and lower cessation rates when compared to Whites.  Almost half (42%) of newly diagnosed patients with diabetes were African American who smoked whereas only 29% (less than a third) that were White smoked.

In general, smoking is associated with a lower body weight so many African Americans resist stopping smoking because of a fear of weight gain.  Many also fail to realize the smoking addiction aspect. 
But in reality the increased smoking actually increases the risk for diabetes.  Smoking is known to produce “pot bellies” which in medical circles is known as “visceral adiposity” and that type of obesity (like in the photo) greatly increases the risk for diabetes.

If diabetes “runs in your family” and you or someone you love is smoking, tell them about this new information and how stopping now can actually DECREASE their risk for diabetes!!

Need more information about Diabetes in African Americans? Click HERE
African American smokers have higher risk for diabetes