Kalp yetmezliği, kalbin vücudun ihtiyaçlarını karşılamak için yeterli kanı pompalayamadığı bir durumdur. Kalp kası zayıfladığında veya hasar gördüğünde, kalbin verimli bir şekilde pompalanmasını zorlaştırdığında ortaya çıkar. Bu, vücutta sıvı birikmesine ve vücudun organlarına oksijen ve besin eksikliğine yol açabilir. Kalp yetmezliğinin yaygın nedenleri arasında yüksek tansiyon, kalp krizi ve diğer kalp hastalığı türleri bulunur.
Ulusal Sağlık Enstitüleri tarafından desteklenen büyük bir araştırma, kırsal alanlarda ikamet eden Siyah erkeklerin en yüksek risk altında olduğunu da ortaya koydu.
Ulusal Sağlık Enstitüleri tarafından desteklenen geniş bir gözlemsel araştırmaya göre, Amerika Birleşik Devletleri’nin kırsal bölgelerinde yaşayan yetişkinler, kentsel alanlarda yaşayanlara kıyasla %19 daha fazla kalp yetmezliği riskiyle karşı karşıyadır. Kırsal alanlardaki Siyah erkekler için risk daha da yüksektir ve kalp yetmezliği gelişme olasılığı %34’tür.
yayınlanan çalışma, JAMA Kardiyoloji ve büyük ölçüde Ulusal Sağlık Enstitüleri’ne (NIH) bağlı Ulusal Kalp, Akciğer ve Kan Enstitüsü (NHLBI) tarafından finanse edilen, kırsal kesimde yaşayanlar, özellikle Siyah erkekler için özel kalp yetmezliği önleme stratejileri oluşturmanın önemini vurguluyor. Amerika’nın kırsal kesiminde yaşamak ile ilk kez kalp yetmezliği vakaları arasındaki ilişkiyi inceleyen ilk çalışmalardan biri olarak, sonuçlar bu konuya daha fazla dikkat edilmesi gerektiğini vurgulamaktadır. Bulgular, Vanderbilt Üniversitesi Tıp Merkezi ile ortaklaşa üretildi.
Çalışmanın ilgili yazarı ve kıdemli bir araştırmacı olan MPH MD Véronique L. Roger, “Kırsal topluluklar arasında, özellikle kırsalda yaşayan Siyah erkekler arasında, kentsel topluluklara kıyasla kalp yetmezliğinde bu büyüklükte bir fark bulmayı beklemiyorduk” dedi. NHLBI’nin Okul İçi Araştırma Bölümü’ndeki Epidemiyoloji ve Toplum Sağlığı Şubesi ile. “Bu çalışma, kırsal kesimde, özellikle de bu bölgelerde yaşayan Siyah erkeklerde kalp yetmezliğini önlemek için özel olarak tasarlanmış araçlara veya müdahalelere ihtiyacımız olduğunu açıkça ortaya koyuyor.”
Tıp fakültesinde dördüncü sınıf öğrencisi olan ortak yazar Sarah Turecamo’yu inceleyin.[{” attribute=””>New York University Grossman School of Medicine, New York City, and part of the NIH Medical Research Scholars Program, agreed. “It is much easier to prevent heart failure than to reduce its mortality once you have it,” Turecamo said.
Researchers from NHLBI and Vanderbilt University Medical Center analyzed data from The Southern Community Cohort Study, a long-term health study of adults in the southeastern United States. They compared the rates of new-onset heart failure among rural and urban residents in 12 states (Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, Virginia, and West Virginia). The population, which included 27,115 adults without heart failure at enrollment, was followed for about 13 years. Nearly 20% of participants lived in rural areas; the remainder lived in urban areas. Almost 69% were Black adults recruited from community health centers that care for medically underserved populations.
At the end of the study period, the researchers found that living in rural America was associated with an increased risk of heart failure among both women and Black men, even after adjustment for other cardiovascular risk factors and socioeconomic status. Overall, the risk of heart failure was about 19% higher in rural residents than in their urban counterparts. However, Black men living in rural areas had the highest risk of all — a 34% higher risk of heart failure compared to urban-dwelling Black men.
The study showed white women living in rural areas had a 22% increased risk of heart failure compared to white women in urban areas, and Black women had an 18% higher risk compared to Black women in urban areas. No association was found between rural living and heart failure risk among white men.
The exact reasons behind these rural-urban health disparities are unclear and are still being explored. Researchers said a multitude of factors may be at play, including structural racism, inequities in access to health care, and a dearth of grocery stores that provide affordable and healthy foods, among others.
“Finding an association between living in rural areas and an increased incidence of heart failure is an important advance, especially given its implications for helping to address geographic-, gender-, and race-based disparities,” said David Goff, M.D., Ph.D., director of NHLBI’s Division of Cardiovascular Sciences. “We look forward to future studies testing interventions to prevent heart failure in rural populations as we continue to fight heart disease, the leading cause of death in the U.S.”
Heart failure is a chronic and progressive condition that develops when the heart does not pump enough blood for the body’s needs. Common symptoms include shortness of breath during daily activities or trouble breathing when lying down. The condition, which has few treatment options, affects about 6.2 million American adults.
Heart failure can be prevented by following a heart-healthy lifestyle. NHLBI’s Roger, who is also a practicing cardiologist, noted one of the biggest contributors to heart failure is hypertension, or high blood pressure, which Black men experience at disproportionately high levels. The condition should be intensively managed by checking blood pressure regularly and taking medications as prescribed. Other ways to reduce heart failure risk include avoiding all forms of tobacco, eating healthy, and exercising.
Reference: “Association of Rurality With Risk of Heart Failure” by Sarah E. Turecamo, BA, Meng Xu, MS, Debra Dixon, MD, MS, Tiffany M. Powell-Wiley, MD, MPH, Michael T. Mumma, MS, Jungnam Joo, Ph.D., Deepak K. Gupta, MD, MSCI, Loren Lipworth, ScD and Véronique L. Roger, MD, MPH, 25 January 2023, JAMA Cardiology.
DOI: 10.1001/jamacardio.2022.5211
Research reported in this study was funded by the NIH Medical Research Scholars Program, a public-private partnership supported jointly by NIH and contributions to the Foundation for the NIH. The research was also supported by the NHLBI’s Division of Intramural Research, the NHLBI Training Award in Cardiovascular Research (T32 367 HL007411), the Intramural Research Program of the National Institute on Minority Health and Health Disparities, the National Cancer Institute (grants R01 CA092447 and 368 U01 CA202979), and supplemental funding from the American Recovery and Reinvestment Act (3R01 CA 029447-0851). The Southern Community Cohort Study is funded by the National Cancer Institute. For a complete listing of funding support, please see the published journal article.