African Americans Still Have Higher Rates of Hypertension, Washington Post Reports

"Nearly 70 years after a New Orleans study first documented clear disparities in blood pressure between blacks and whites, hypertension is still an unequal opportunity killer," the Washington Post reports in the July 10 health section. Today, one in three African Americans overall, and one in two black men, have high blood pressure, compared with one in four whites. Blacks also develop hypertension earlier in life, the Post reports. The disease also is "deadlier" for blacks; African Americans have a 50% higher death rate from heart disease and an 80% higher death rate from stroke than whites. Several "theories" could explain the disparity, such as "diet, genes, ethnic behavior, racial discrimination, socioeconomics and the stresses of urban life," the Post reports. But "[o]ne sure cause" of African American's higher mortality rate from hypertension is their "lower rate of treatment." Even though a "popular" form of intervention is "community screenings" to diagnose high blood pressure, there typically is no follow-up after such screenings, the Post reports. Elijah Saunders, a medical school professor at the University of Maryland, said that follow up requires money "and the fact is we don't have the money we need. ... Getting people into care once they're screened can be impossible. Many don't have insurance, or they're unemployed, or they can't afford the medication." As a result, few African Americans with hypertension take blood pressure medication or follow recommendations to change their lifestyles and diets, the Post reports. Further, there exist "too few programs" near large black populations to increase the numbers of African Americans in treatment. Data from the CDC show that 79% of black men with high blood pressure "aren't getting it under control," compared with 74% of white males. Claude Lenfant, director of the National Heart, Lung and Blood Institute, said that although hypertension is "a huge problem, ... the truth is, we aren't doing the job of solving it."

Making a 'Modest' Difference
There is one program in the Washington, D.C., area that has "made a difference ... in a modest way and on a small scale," the Post reports. Started in 1992 by researcher Martha Hill, the program recruited 305 black men with hypertension and employed community health workers to "keep tabs" on the patients, making them aware of the risks, "encourag[ing]" them to change habits and "nudg[ing]" them to take their medicine. The program, funded by the NIH, produced "safe levels" of blood pressure in 39% of the participants, compared with 27% of the group that community workers "previously assumed" were open to changing their lifestyle or diet. The program's success is "not a complete or even dramatic victory, but a demonstrable improvement," the Post reports (Epstein, Washington Post, 7/10).