Heart disease remains one of the leading causes of death among Black Americans. Clinical trials are crucial in developing effective treatments and prevention strategies as we strive to address this health disparity. However, the underrepresentation of Black Americans in these trials has long been a concern. Dr. Jayne Morgan, a cardiologist and vice president of Medical Affairs at Hello Heart, sheds light on this issue and explains why participation in heart health clinical trials is vital for the Black community.
The Underrepresentation Problem
Dr. Morgan highlights the stark reality of the current situation: “By and large, Black people don’t really participate in clinical trials.” This lack of participation stems from historical mistrust and a healthcare system that has not always prioritized the needs of Black Americans. However, this underrepresentation has far-reaching consequences.
“Basically, white men are the ones who are enrolled in these trials,” Dr. Morgan explains. “And so the only thing we really know when the FDA approves the data is whether it works or not on white men.” This narrow focus is particularly concerning when considering that “white men only comprise 9 percent of the global population.”
The Importance of Representation in Clinical Trials
Dr. Morgan emphasizes that representation in clinical trials is not just about genetics but about capturing the diverse lived experiences of different populations. She states, “What we’re talking about is how we live, how we eat, products we use, how we interact with the environment. All of those things are different, and they come to play.”
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This diversity in lifestyle and environmental factors can significantly impact how medications and treatments affect different populations. Without adequate representation in clinical trials, potential side effects or variations in effectiveness may go undetected until after a drug is approved and widely prescribed.
The Benefits of Participating in Clinical Trials
Contrary to common misconceptions, participating in clinical trials can offer significant benefits, especially for those with limited access to healthcare. Dr. Morgan reveals, “If you are uninsured or underinsured, generally, if you are enrolled in a clinical trial, all of your health costs, your medications are covered by the drug company.”
Moreover, participants receive a level of care and attention that is often unparalleled in routine medical settings. “You’ve got all of these doctors watching you, and you generally have a nurse or some other research specialist with whom you have direct communication… and you can reach them twenty-four hours a day as long as you are participating in that trial,” Dr. Morgan explains.
Overcoming Barriers to Participation
One of the main barriers to Black American participation in clinical trials is the lack of trusted voices encouraging involvement. Dr. Morgan notes, “The number one reason that all people of any race, of any gender, of any creed in this country, participate in clinical trials, the number one reason is that a trusted physician approached you about it.”
However, she points out a significant challenge: “Most principal investigators, these are the doctors who are leading the clinical trials, are white men, more than 92 percent.” To address this, Dr. Morgan suggests that “big drug pharma device companies have to begin to recruit Black physicians and train them as principal investigators.”
The Connection Between Heart Health and Pregnancy
An often-overlooked aspect of heart health for Black women is the connection between pregnancy complications and future heart disease risk. Dr. Morgan explains, “We now know that patients who have had those complications of pregnancy have a two to threefold increased risk of heart disease later.”
This risk is particularly concerning for Black women, who “have the highest rate of preeclampsia, more than seven percent.” Dr. Morgan advocates for better integration of cardiac care into obstetric practice, suggesting the creation of “cardiac [obstetrics] units” to address this issue.
Taking Action for Better Heart Health
For those interested in participating in heart health clinical trials, Dr. Morgan encourages proactivity. “You can ask your doctor about it, especially if you have a chronic medical condition and or if you have something that’s rare,” she advises. She also suggests exploring university websites for information on ongoing clinical trials.
Ultimately, Dr. Morgan urges Black Americans to shift their perspective on clinical trials: “I want us to begin to move our thoughts away from exploitation and more towards representation and to begin to think about what that means within clinical trials.”
By increasing participation in heart health clinical trials, Black Americans can play a crucial role in improving heart health outcomes for their community and ensuring that future treatments are effective and safe for all populations.
