Why are African Americans at greater risk?

African Americans are at a much higher risk for heart failure in part because more of them develop high blood pressure and diabetes than other ethnic groups. Some scientists suspect that low levels of nitric oxide, which relaxes blood vessels, may also play a role.

High blood pressure

High blood pressure is the most common cause of heart failure in African Americans. It affects a greater percentage of African Americans than other Americans. Researchers have also learned that in African Americans high blood pressure tends to cause more damage to their organs, including the kidneys and heart.

High blood pressure is called a "silent killer" for good reason. Without regular blood pressure checkups, it can go unnoticed, gradually wearing down your heart and blood vessels. High blood pressure can also run in families, so if your parents or grandparents had this condition, you're at greater risk for developing it. Taking medication that lowers your blood pressure as needed and adopting some heart-healthy habits can go a long way toward preventing heart failure.

Diabetes

A higher rate of diabetes may also be to blame for the higher risk of heart failure among African Americans. Diabetes has been called an epidemic in the African American community, particularly among women.

Type II diabetes (which usually doesn't begin until you're an adult) is the most common form of diabetes. It can often be prevented by losing excess weight, eating right, and getting regular exercise. Your doctor can find out if you have diabetes by doing a simple blood test. Diabetes can sometimes be prevented or managed by taking medication regularly and adopting some healthy habits.

The nitric oxide connection

Researchers have also begun to suspect that some aspects of basic body chemistry may work differently depending on ethnicity. This theory, as yet unproven, is based on studies showing that African Americans sometimes respond differently to medications than Americans from other ethnic backgrounds.

For example, studies show that African Americans may be more likely to have impairment in the ability of their blood vessels to relax. Some researchers suggest this may have something to do with the amount of nitric oxide available in their bodies. When blood vessels stay narrow, it can interfere with the heart's ability to pump blood as well as it should. Nitric oxide is a compound that works to relax blood vessels — including those in your heart — so more blood can flow through as needed.

Other possible causes

Other theories about why African Americans' risk for heart failure is higher include:

• Less access to good health care services and relevant health information
• More exposure to environmental risks like pollution
• A greater tendency to be overweight and to get less exercise

Based on information from the American Heart Association and the U.S. Census Bureau, it is estimated that there are approximately 750,000 African Americans with heart failure in the United States and this number is expected to grow to 1 million by 2010.

African Americans at Higher Risk

While anyone can be affected by heart failure, it hits the African American community the hardest:

• Heart failure has a more aggressive natural history in African Americans
• In African Americans, heart failure occurs at an earlier age and is associated with more advanced disease at diagnosis
• In African Americans, heart failure is more likely to be associated with a history of hypertension
• African Americans require hospitalization for heart failure more frequently and at a younger age than do whites

Information for Patients about BiDil®

BiDil is approved for use in addition to routine heart medicines to treat heart failure in black patients, to extend life, improve heart failure symptoms, and help patients stay out of the hospital longer. There is little experience in patients with heart failure who experience significant symptoms while at rest. Most patients in the clinical study of BiDil received routine heart failure medicines.

Important Safety Information

Tell your doctor about any allergies you have, especially if you're sensitive to nitrates, such as nitroglycerin tablets or isosorbide dinitrate (Sorbitrate® or Isordil®). BiDil has a nitrate component, so you need to let your doctor know.

Tell your doctor if you're taking any erectile dysfunction or pulmonary hypertension drugs, like Viagra®/Revatio™ (sildenafil), Levitra® (vardenafil) or Cialis® (tadalafil). Mixing these with BiDil may cause a sudden drop in blood pressure, fainting, chest pain, or heart attack.

Also tell your doctor if you are taking any medication to decrease blood pressure because when taken with BiDil, blood pressure may become too low.

Drinking alcohol when taking BiDil could make you feel very lightheaded. We recommend that you try to avoid drinking alcohol while taking BiDil.

It is possible you'll get headaches, especially at first. For some patients, Tylenol® (acetaminophen) helps ease the discomfort. Keep your doctor posted on your headache progress and Tylenol use; he or she may want to adjust your dosage.

If you experience dizziness, call your doctor. Please make sure to tell your doctor about any of the signs or symptoms mentioned below or about any unusual events that worry you.

Drinking less fluids than your doctor recommends or losing fluid due to diarrhea, sweating, or vomiting may cause low blood pressure, lightheadedness, or fainting. If fainting occurs, stop taking BiDil and contact your doctor immediately.

Lightheadedness may occur when standing, especially after sitting or lying down.

If you experience any achy and/or swollen joints, unexplained fever for more than a few days, skin rashes, chest pain, prolonged weakness or fatigue (even after a good night's sleep), or any other unexplained signs or symptoms, make sure to tell your doctor as they may be signs of a serious medical condition.

You may also experience rapid heartbeat that could lead to chest pain or aggravate chest pain, or numbness or tingling in the hands or feet.

Sorbitrate is a registered trademark of AstraZeneca LP; Isordil is a registered trademark of Bioavail Corporation; Viagra is a registered trademark and Revatio is a trademark of Pfizer Inc.; Levitra is a registered trademark of Bayer Healthcare, GlaxoSmithKline, and Schering-Plough; Cialis is a registered trademark of Lilly ICOS LLC. Tylenol is a registered trademark of McNeil Pharmaceuticals, a Division of McNeil PPC, Inc.

Please see full Prescribing Information for BiDil.