By Andrea L. Lowe, MPH, SWHR Health Policy and Public Health Liaison
February is both Black History Month and American Heart Month. In support of both events, the Society for Women's Health Research (SWHR) would like to encourage African American women to take charge of their health and participate in clinical research opportunities designed to reduce their likelihood of heart disease during their lifetime.
African American women have the highest percentage of hypertension.  According to the American Heart Association, 46 percent of African American men and 48 percent of African American women have cardiovascular disease; 3.4 percent of men and 2.2 percent of women have had a heart attack; and 4.2 percent of African American men and 4.8 percent of African American women have had a stroke. And nearly 50,000 African American women die each year from cardiovascular diseases.
Despite this, black women (as well as other minorities and women in general) have traditionally been vastly underrepresented in clinical trials studying the safety and effectiveness of cardiovascular disease drugs.  A 2019 review published in the Journal of the American College of Cardiology study examining the representation of women in general and minorities in cardiovascular disease clinical trials found that women and minorities were underrepresented in all 130 major cardiovascular disease studies. 
In addition to limited recruitment of black women in clinical trials, researchers have found that a history of medical abuse of minority populations in the United States contributes to lower participation rates. Historically, black men and women have often been exploited for medical knowledge, such as use for dissection and medical demonstration during slavery, as well as more recently with the Tuskegee Syphilis Study that continued into the 1970s, which denied participants treatment after medication was available to cure the disease. 
But these injustices are not the only reason for low participation rates in clinical trials. Researchers from the University of Illinois at Chicago found four major barriers to participation: (1) lack of awareness, (2) economic factors, (3) communication issues, and (4) mistrust. While survey participants in this study were afraid of being treated as "guinea pigs," the researchers also found that only 5.4 percent had ever participated in a clinical trial and only 15.8 percent were ever asked to participate. Meanwhile, 68 percent of the respondents indicated that they would consider participating if asked. 
In response to the increased need for diverse women to participate in medical research, the U.S. Food and Drug Administration recently launched its "Women in Clinical Trials" initiative. The website includes answers to common questions about clinical trials, "15 Things to Know," and the opportunity to find clinical trials currently recruiting participants in your area. 
Every woman considering joining a clinical trial should know its purpose and what is expected to happen during the study, the possible risks and benefits, additional support (such as child care or transportation) and costs, as well as how to find out more information before making the decision to participate. 
Amid the many events and celebrations for Black History Month and American Heart Month, take time to consider your health and contribute to future advancement in treatments for minorities by participating in a clinical trial. More information on SWHR's long history of supporting clinical trial participation by women and minorities can be found on our website.
- "Most African Americans Have High Blood Pressure Before Age 55." The National Heart, Lung, and Blood Institute. July 2018. https://www.nhlbi.nih.gov/news/2018/most-african-americans-have-high-blood-pressure-age-55. Accessed December 2019.
- "Women and heart disease." The United States Centers for Disease Control and Prevention. May 2019. https://www.cdc.gov/heartdisease/women.htm. Accessed December 2019.
- "African Americans and Cardiovascular Disease." The American Heart Association. 2015. https://www.heart.org/idc/groups/heart-public/@wcm/@sop/@smd/documents/downloadable/ucm_472910.pdf. Accessed December 2019.
- "Heart disease in African American Women." The American Heart Association, GoRed for Women. 2019. https://www.goredforwomen.org/en/about-heart-disease-in-women/facts/heart-disease-in-african-american-women. Accessed December 2019.
- "Racial and ethnic minorities in clinical trials." The United States Food and Drug Administration. https://www.fda.gov/consumers/minority-health-and-health-equity/racial-and-ethnic-minorities-clinical-trials. Accessed December 2019.
- "Minority representation in cardiovascular clinical trials." Journal of the American College of Cardiology. Volume 73, Issue 9 Supplement 1, March 2019 DOI: 10.1016/S0735-1097(19)33651-4. http://www.onlinejacc.org/content/73/9_Supplement_1/3045. Accessed December 2019.
- Harris Y, Gorelick, PB, Samuels P, Bempong I. "Why African Americans may not be participating in clinical trials." J Natl Med Assoc. 1996;88: 630-634. https://www.ncbi.nlm.nih.gov/pubmed/8918067. Accessed December 2019.
- "Women in clinical trials." The United States Food and Drug Administration. 2019. https://www.fda.gov/consumers/womens-health-topics/women-clinical-trials. Accessed December 2019.