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Q&A: Shaq 'gets real' about HF awareness in black population
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PHILADELPHIA — Shaquille O’Neal, PhD, FHFSA, retired basketball star and winner of four NBA championships, discussed the recently launched campaign Shaq Gets Real, which focuses on raising awareness about HF in the black population and providing support for improved access to medication and treatment, at the Heart Failure Society of America Scientific Meeting.
Joining O’Neal, Elizabeth Ofili, MD, MPH, FACC, professor of medicine and director and associate dean of the Clinical Research Center and clinical and translational research, founder and chief medical officer at AccuHealth Technologies Inc. and past president, chair-elect and board member of the Association of Black Cardiologists, highlighted many of the existing disparities that put African Americans at a higher risk of HF.
Concluding the 2019 scientific meeting, Randall C. Starling, MD, MPH, FHFSA, outgoing president of HFSA and director of the heart transplant program and mechanical circulatory support at Cleveland Clinic, named O’Neal an honorary fellow of HFSA.
Healio spoke with O’Neal and Ofili regarding their joint efforts to inform black individuals about HF and to minimize racial disparities in prevalence and treatment of HF.
Question: What motivated you to get involved in raising awareness about heart failure in the black population?
O’Neal: Dr. Ofili informed me that 5.5 million Americans are affected by this disease, but it hits the African American community very hard. I do not suffer from HF, but I feel it's important to inform people and help people about it. That's why we started the website shaqgetsreal.com.
For 40 years I lived under the aura of invincibility. My only belief of a doctor was the NBA physical. Just getting cleared to play meant I was fine. The first day I met her, Dr. Ofili asked me, if I had a doctor? I told her, no. She said "What do you mean?" I said, "I'm fine. I don't need a doctor."
I realized that that's the attitude of most people. So, we want to encourage people to go get checked at least once or twice a year. Especially the African American community, because we get hit the hardest when it comes to heart failure.
Q: How did you both come together to work on this campaign?
Ofili: I've been involved with the whole notion of unequal treatment of African American patients, starting with my affiliation with the Association of Black Cardiologists. Back in the late ’90s, there wasn’t a good treatment for HF. So, in 2000, the A-HeFT study was launched that showed significant benefit of isosorbide dinitrate/hydralazine (BiDil, Arbor Pharmaceuticals) for African American patients. Since then, I've continued to be involved through the Association of Black Cardiologists in raising awareness, and that's how I first met Shaq. I was sharing with him, not just the data behind the study but what's going on now in care. He asked me, "So, what's the problem?" I said, "Doctors aren't prescribing and sometimes patients cannot afford medication." That's the intersection of his engagement, that he wants to do something about this.
Q: Why is there such a disparity in HF between the black and white communities?
Ofili: These disparities are multifocal. The risk factors that lead to HF include high BP, diabetes and suffering from a MI. But the challenge is if you don't get checked and are not aware you have those conditions, by the time you're diagnosed, it's too far into the disease.
BP has been poorly controlled for many years, which creates a problem at the time of presentation. Then, there's a significant access issue. You may have to have access to a doctor, and you may know that you need to get checked up regularly, but you also need to have access to the treatments. All of these antihypertensive drugs or diabetes drugs still have a price tag. Sometimes people have to balance what they are going to pay for.
Q: Can you describe some of the features of a shaqgetsreal.com and how it helps spread awareness?
O’Neal: If you can't afford medication, we'll help you out. This is very important to me. When I asked her what the problem was, we talk about affordability. To help promote this, I had to be sure that everybody can go get hold of the medication. There will also be videos and some additional information, but basically what it is telling you is to just please get checked up.
Ofili: Understanding what HF looks like, what kinds of symptoms to look for and what should they ask their doctor are all complex things. You can get information on these topics from the website. In a way, it demystifies the process, so people are not as afraid to go off to the doctor and ask.
Q: What are some of the keys to trying to dissolve these disparities?
Ofili: Awareness is a big part of that. You don't really know how to engage a problem if you're not aware of it; that it affects you and your family. Once you understand your risk, how you need to know how to advocate for the care that you actually receive? Also, not every doctor you talk to knows what works best for you. Then there's the issue of access to the treatment itself. Those are all things that, if done consistently, data have shown that we can begin to dissolve the disparities.
Q: Aside from presenting at HFSA, what else are you doing to promote Shaq Gets Real?
O’Neal: To spread the word, I've been meeting with a lot of people, we've had four to five interviews per day. Coming up, we've got another live forum in front of about 500 to 600 doctors.
Again, a lot of [people at risk for HF] just don't know. We want to inform and we just want them to understand that I'm here to help people. I've always been very vocal about helping people, helping those in need, and this disease affects my community the hardest. I have a voice; I have a platform and I speak their language. Their language is simplicity. I can say, "Hey man, go get checked out. If not, this could happen to you." They'll see all of that; they'll see the examples that we have and then hopefully change their mind and their outlook.
Ofili: Shaq's also partnered with the Association of Black Cardiologists and he'll be at our meeting, Spirit of the Heart in Los Angeles. He's spreading the word to doctors who need to recognize the problem and act on it. So, we're just grateful for his leadership in this space.
Q: What kind of potential do you think Shaq gets real can have on impacting this issue?
Ofili: It has a significant, tremendous potential. People know that there is a problem or at least sense it as a problem, but having someone like Shaq lend voice to the problem, saying that it does matter that we get checked out and that it does matter that we seek the best treatment. I think this is going to have tremendous impact and we're very excited about that.
Q: Once you've made someone aware of the issues surrounding HF, what would you tell them is the next step into resolving this issue?
O’Neal: I always tell them that I'm not a medical professional. But after step one, becoming aware of the issue, you need to seek professional help. Listen to your doctor, someone that you love and that you trust. My job is to get them there. Once you get them there, the doctor will know what to look for.
I always tell people that you should consult your physician once, twice, even three times per year. I'm just guiding them to the door. For example, I can't tell you what's in Whole Foods, but I know exactly where it is. You go in there; you got all the healthy stuff you need. I don't try to act like an expert in this space, because I'm not. My job is to communicate with the people that think like me and then once they meet with their physicians and they meet more intelligent people like Dr. Ofili, those doctors can inform them. That's why it's called Shaq Gets Real. I'm not saying I'm an expert, but I am saying to consult with your physician, talk about symptoms. I'm saying that, if you're African American, this is an option. – by Scott Buzby
Reference:
Ofili E, et al. Special Session: HF Awareness in African Americans. Presented at: Heart Failure Society of America Scientific Meeting; Sept. 13-16, 2019; Philadelphia.
Disclosure: Shaq Gets Real is a partnership with Arbor Pharmaceuticals. Healio was unable to obtain O’Neal and Ofili’s relevant financial disclosures at the time of publishing.