LUMBERTON — Doctors have long seen a trend among Lumbee patients with cardiovascular diseases: They tend to be younger and female, defying the typical risk population of older men. Now Duke Medical researchers have the green light to start looking for genetic links in that anomaly, which they hope will lead to effective prevention measures.

“In finding a link, it may be possible to develop a blood test that could be performed at an early age that could tell us if a person was at risk for premature cardiac artery disease,” said Dr. Terry Lowry, a cardiovascular surgeon at Southeastern Regional Medical Center. “Then we could start aggressive primary prevention measures.”

Lowry’s grandmother, a Lumbee, had coronary artery disease and had several heart attacks.

“I grew up in the area, and so I’m well aware of the numbers of people who have premature bypass surgery,” said Lowry, a Prospect native.

Cardiovascular disease is the No. 1 cause of death in Western societies, representing 40 percent of all deaths in the United States — more than all cancer deaths combined, according to the Mayo Clinic. Cardiovascular disease encompasses coronary artery disease, arrhythmia, and congenital heart defects.

Usually men are more at risk of heart disease; a person’s risk increases with age, and people with a family history of cardiovascular diseases are more likely to suffer from one. There are also a number of lifestyle factors: smoking, poor diet, obesity, physical inactivity, poor hygiene and high stress.

Centers for Disease Control statistics show that Robeson County has among the highest heart disease hospitalization and mortality rates in North Carolina, ranked 95th of 100 counties for the number of people hospitalized for heart-related diseases each year and 92nd for annual deaths from heart disease.

“Duke has cared for the Lumbee population for years through local clinics. CVD usually runs in a whole family, or they develop symptoms,” said Amy Kessenich, director of the Southeastern Heart Center and manager of Duke Medical in Lumberton.

The Duke Medical study is looking for genetic links to premature coronary artery disease among Lumbees in hopes of reducing the number of people in their 30s and 40s who have bypass surgeries, Lowry said.

“It’s something that the cardiologists at Duke have been looking at for a while,” Lowry said. Lowry said he met with cardiologists interested in doing the study before SRMC’s Heart Center opened in May 2006.

“We don’t know if (the Lumbee) population is predisposed, but we suspect it is hereditary,” Kessenich said.

Researchers will need 1,000 volunteers who meet the study’s requirements: Lumbees with at least two family members who have had cardiovascular disease; men must have been diagnosed by age 51 and women by age 56. Participants will give blood samples at the hospital or the Heart Center. After the blood test is submitted, researchers will check in with the patient occasionally, and a year later conduct a follow-up evaluation.

The research team spent more than a year writing the study proposal, which was approved by Duke and SRMC last month. One of the lead researchers, Dr. Svati Shah, and the Duke Genetic Department are sponsoring the study.

Shah is a cardiologist who has been investigating genetic links to cardiovascular diseases in Lumbees since she was involved in a Duke study that found Lumbees with heart problems often don’t match the usual risk population.

The study, presented at a 2006 meeting of the American College of Cardiology, found that 920 Lumbees hospitalized for heart problems not only had considerably higher rates of cardiovascular disease risk factors — diabetes, high blood pressure, history of coronary heart disease — than non-Lumbees, but also patients tended to be younger and female.

The study also found that while the mortality rate among Lumbee heart patients paralleled that of other ethnicities, Lumbees were more likely to have had at least one heart attack prior to the fatal heart attack. Despite their increased incidence, Lumbees had a lower rate of heart procedures to open clogged arteries, according to the study.

According to statistics compiled by the American Heart Association, men are more prone to heart-related diseases than women; black men and women are more prone to heart-related diseases than white men and women. Black men and women have higher incidences of high blood pressure and hypertension, and white people have higher incidences than Hispanic people.

Sickle cell anemia and cystic fibrosis are among the disorders with strong genetic links in certain ethnicities. Sickle cell anemia is most commonly found in black and Hispanic people, and cystic fibrosis mostly affects white people.

So far the strongest genetic link for cardiovascular disease is among family members. At John Hopkins, one of Shah’s alma maters, a research team found a strong hereditary link between siblings and heart disease. The study, published in November 2007, shows that siblings, regardless of age or lifestyle, have a higher risk of a heart attack or coronary artery disease if a sibling suffers one.

The study found that brothers are more strongly linked than sisters; the chance of a healthy brother developing a cardiovascular disease rises 20 percent within 10 years of his brother showing symptoms, while a sister’s chance rises 7 percent.

The younger the sibling who first develops a cardiovascular disease, the higher chance other brothers and sisters will develop similar problems, the study shows. Siblings who were obese increased their chance of heart-related diseases by 60 percent.

Researchers determined genetics played a role in cardiovascular disease, but the study did not reveal how genetics factored in; one researcher theorized people could be genetically vulnerable to risk factors — weight, age, gender, high blood pressure, and high cholesterol.

John Hopkins researchers shared Duke researchers’ current goal: To develop a blood test for people prone to cardiovascular disease in order to start prevention efforts early.

“This will help us to better understand what the precursor to CVD is so that we can prevent that for future generations,” Kessenich said.

To enroll in the study, contact Rachel Locklear at Southeastern Regional Medical Center, rl62@duke.edu or (910) 735-8807.