Young pleasant female doctor talking to african american woman patient, showing the clipboard with

Hypertension among Black Americans is among the highest in the world.

Currently, the American Medical Association (AMA) is working to achieve optimal health for all. To do that, they need to work at the community level to bring health equity to minority communities in the U.S.

A recent article in JAMA (the Journal of the AMA) showed that hypertension is wreaking havoc on the Black population in the U.S. A new study showed that more than half of Black women over the age of 20 have high blood pressure. But within that statistic it was found that Black women often make critical healthcare decisions and dietary choices for their families, so there are things that can be done. 

The AMA – in collaboration with the AMA Foundation, Association of Black Cardiologists (ABC), American Heart Association, Minority Health Institute, and National Medical Association – launched the “Release the Pressure” (RTP) campaign in 2020 to give Black women the resources they need to measure and track their blood pressure (BP), as well as make healthy lifestyle changes for themselves and their families.

The theme of the event was education, with presenters focusing on these key topics:

Know what high BP looks like. Blood pressure is typically considered elevated when the top number is 120 to 129 and the bottom number is less than 80, but it is high when the systolic (top number) is 130 or higher or the diastolic (bottom number) is 80 or higher. These numbers were recently adjusted.

Learn how to measure your BP at home. One of the best investments that you can make in yourself is to actually invest in a validated home blood pressure device, one official noted, adding that validatebp.org is the recommended source for validated devices in the U.S.

Take your medications as prescribed. Cardiologists and internal medicine physicians alike preach this consistently. Chronic conditions can be managed when patients follow physicians’ orders.

Track your progress. The AMA and ABC, along with the Minority Health Institute, on their collaborative RTP website, featured a seven-day recording log, with two slots for each morning and evening. It also includes instructions for accurately measuring BP at home, with a graphic and video.

Know what you’re trying to do. The most important part of the RTP Heart Health Pledge, which is a cornerstone of the Release the Pressure campaign, is creating a heart health plan, according to Rachel Villanueva, MD, a clinical assistant professor of obstetrics and gynecology at the NYU Grossman School of Medicine and the 122nd president of the National Medical Association.

“It is really so important to find a health home – a healthcare provider who knows you well, knows your family history,” she advised. Release the Pressure is dedicated to introducing Black women to healthcare providers who look like them through its regular events.

Make healthy lifestyle changes. Target at least two and a half hours of walking per week, for example. “Really working your heart improves your heart health,” Dr. Villanueva said. “Twenty, 30 minutes a day – just get outside. Put that on your schedule right away, so there’s nothing that that conflicts with it.”

The National Institutes of Health (NIH) National Library of Medicine revealed the results of an April 2021 study, with its background noting that the prevalence of hypertension in Blacks is among the highest in the world. For Black women, 46 percent experience stage 2 hypertension (blood pressure ≥ 140/90 mm Hg), compared with 42 percent of Black men. Because of higher rates of stage 2 hypertension, Black women have greater rates of cardiovascular disease and stroke.

An understudied potential factor associated with poor adherence to treatment regimens and negative health outcomes is stigma. Hypertension stigma could potentially deter adherence to high BP treatment.

Five themes were generated inductively from the data, and included a) desire to get control; b) shame and embarrassment; c) obesity characterizations; d) stereotype threats; and lastly, e) disrupted normality. During member checking, younger participants were more vocal about stigma, whereas older participants did not view stigma as problematic.

Conclusions reached were that further research is needed to explore the prevalence of stigma in this patient population and its impact on behaviors that hinder BP control.

Lastly, the American Heart Association News reported that certain contributing historical and socioeconomic factors can influence this disparity. For example, Dr. Willie M. Abel, the study’s lead researcher, stated that “Black women are different from women of other racial/ethnic groups. We know there are a lot of factors that influence stress frequency, intensity, and duration that differ from other women, and contribute to hypertension and its adverse effects. We are just beginning to study the root of the problem and interventions to effect change.”

It was also pointed out that many Black Americans distrust the medical community because of a track record of mistreatment, or unequal treatment, revealed through racial disparities in healthcare. Many Black men and women will not visit doctors regularly, and even if they do, they may not take medications as prescribed.

The Release the Pressure campaign encourages Black women to take the pledge to lower their blood pressure, as well as to set a goal, monitor their BP at home, activate a personalized wellness plan, and join a “squad” of women committed to putting their heart health first.

The AMA has created a toolkit to help health professionals raise awareness of the Release the Pressure campaign and ensure that every American has access to the conditions, resources, and opportunities to achieve optimal BP.

But it is also up to physicians to recognize the racial disparity in high blood pressure diagnoses, and encourage patients of color to talk to them about their health concerns without worry of inequitable treatment and stigmas.

Program Note: Listen to Terry Fletcher report this story live today during Talk Ten Tuesdays, 10 Eastern.

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