As Heart Awareness Month concludes, leaders within the African American medical community are urging renewed attention to a crisis that continues to claim Black lives at higher rates, even as overall cardiovascular deaths decline nationwide.
Dr. Anthony Fletcher, the 20th president of the Association of Black Cardiologists (ABC) and an interventional cardiologist at CHI St. Vincent Cardiology and Medicine Clinic in Little Rock, Arkansas, said the month provides a necessary moment to pause and confront persistent disparities that remain embedded in the health care system.
“Every month should be Heart Month, and every month should be Black History Month,” Fletcher told The Washington Informer. “This is an opportunity to focus, to pause for a moment, and to think about the significance of both.”
Fletcher was installed as president of the ABC during the organization’s spring 2024 membership meeting in Atlanta. Founded in 1974, ABC has a global membership exceeding 2,000 health professionals and advocates committed to improving cardiovascular outcomes in minority communities.
While advances in cardiovascular care have driven down death rates over time, Fletcher said recent trends are concerning. He pointed to an upswing in cardiovascular deaths that many clinicians associate with rising diabetes and obesity rates.
“Despite the improvements, there is still a gap in deaths among people of African American descent in this country,” said Fletcher, who specializes in all aspects of clinical cardiology, with an emphasis on patient education and prevention, especially in minority and underserved populations. “The numbers are coming down, but Black people still die at higher percentages compared to our white counterparts.”
Hypertension remains one of the most pressing threats. A veteran doctor who has served patients across Central Arkansas for more than three decades, Fletcher said high blood pressure often develops earlier in Black Americans, sometimes beginning in the late teens, and tends to be more severe.
“It puts us at higher risk for congestive heart failure, kidney failure, and stroke,” he said. “Heart failure overall is rampant in the African American community.”
A graduate of Xavier University and the University of Cincinnati College of Medicine in Ohio, Fletcher also highlighted transthyretin amyloid cardiomyopathy, known as ATTR-CM, a genetic condition that disproportionately affects Black Americans and is frequently overlooked.
“It gets missed, even by doctors,” Fletcher said. “But ATTR is just one of many cardiovascular illnesses that disproportionately affect African Americans.”
Paying Attention to Symptoms, Accessing Care
Black Americans who have lived through delayed diagnoses and limited access to specialty care said they hope Heart Awareness Month reminds everyone of the importance of paying close attention to health matters.
“By the time I realized the shortness of breath wasn’t just stress, I had already been to urgent care twice and left feeling brushed off,” said Audrey Wright, 38. “Chest pain is not the only warning sign. Fatigue, jaw pain, nausea, swelling in the legs, and getting winded doing ordinary things can be the heart waving a red flag.”
Maurice Boyd, 52, said geography nearly cost him his life.
“I live in what they call a cardiology desert,” Boyd said. “I learned I couldn’t afford to be passive. I walked into that office with receipts, not vibes. Heart care has to be treated like a plan, not a wish.”
Jeannette Coleman, 67, said family history should never close the conversation.
“My father died young, so I thought I was ready for this, but you’re never ready,” Coleman said. “Do not normalize high blood pressure, and do not accept ‘It runs in your family’ as the end of the conversation. Family history is information, not a sentence.”
Beyond individual risk factors, Fletcher said geography plays a decisive role in who receives timely care. He described what clinicians call cardiology deserts, areas with limited or no access to cardiologists.
“There are at least three million African Americans who live in areas where they have access to no cardiologists whatsoever,” Fletcher said. “Another 16 million live in places where access is limited.”
To confront those barriers, ABC launched its Cardiovascular Desert Initiative, a campaign started about five months ago and sponsored in part by Amgen. The pilot focuses on Georgia, Mississippi, Louisiana, and Arkansas, with host cities including Atlanta, Jackson, New Orleans, and Little Rock.
The initiative takes a two-pronged approach. One arm focuses on communities, beginning with LDL-C cholesterol screenings and education around modifiable risk factors. The other arm centers on providers, offering education on national guidelines, consultation access, and direct relationships with cardiologists.
Fletcher said there’s a clear call to action.
“We want providers to be able to pick up the phone and call a cardiologist when a patient is not responding to treatment,” he said.
‘We Still Have a Gap. We Just Need to Work Harder‘
The ABC president explained that progress is visible, pointing to a growing number of Black cardiologists and improved enrollment of Black Americans in clinical trials. Still, he said more work remains.
“We still have a gap,” Fletcher demanded. “We just need to work harder, enhance the workforce, and improve educational opportunities for early detection and early treatment.”
The decorated physician noted the work must remain clear and sustained.
“The first step is awareness,” Fletcher said. “We have risk factors that can be modified, hypertension, cholesterol, weight, activity levels, smoking. People need screening programs, early physicals, and to know their numbers, blood pressure, weight, sugar, cholesterol.”
He said treatment must follow evidence-based goals.
“Too many people are seen by providers but are not treated to goal,” Fletcher acknowledged. “Access matters. Education matters. Funding matters, so people can be screened and have access to the medications they need.”