Study Shows 8,000 African-Americans Die Due to Blood Pressure Gap

November 12, 2008

The lives of nearly 8,000 black Americans could be saved each year if
doctors could figure out a way to bring their average blood pressure
down to the average level of whites, a surprising new study found.

The gap between the races in controlling blood
pressure is well-known, but the resulting number of lives lost startled
some scientists.

expected it to be big, but it was even larger than we anticipated,”
said the lead author, Dr. Kevin Fiscella of the University of Rochester
School of Medicine & Dentistry.

The study, released Monday in the Annals of
Family Medicine, is being called the first to calculate the lives lost
due to racial disparities in blood pressure control.

said he believes steps can be taken to erase that gap. But a second
article in the same journal found that racial differences in blood
pressure treatment persisted in England despite a national health
system that provides equal access to care.

may not be providing proper care, but some black patients may not be
taking prescribed medicines or following medical advice, said
Christopher Millett of the Imperial College of London.

However, another researcher said it is unfair to blame the patient.

to me is a hateful word. It says, ‘I the great doctor and we the great
health care service inform you what needs to be done and you don’t do
it because you’re stupid, you’re incompetent’… I don’t accept that at
all,” said Dr. Jeremiah Stamler, professor emeritus of preventive
medicine at Northwestern University’s Feinberg School of Medicine.

Silent killer
blood pressure — often called the “silent killer” because it has no
symptoms — increases a person’s chances for heart disease, stroke and
other serious problems. But it’s easy to check for and usually can be
controlled through exercise, diet and medicine.

decades, doctors have noted that a higher percentages of black
Americans have high blood pressure than whites. The reasons for that
include poverty and cultural habits. Both can prevent people from
exercising, eating healthy foods and getting in to see a good doctor.

study suggesting 8,000 black lives are lost due to uncontrolled blood
pressure is based on earlier research that finds that about 40 percent
of black adults have high blood pressure, compared with about 30
percent of whites.

and his colleague, Kathleen Holt, made a series of calculations. They
took estimates of how each point of increased blood pressure affects
the likelihood of death, and put it in a formula that included the
difference in black and white blood pressure readings.

Those differences caused about 5,500 extra deaths from heart disease and about 2,200 deaths from stroke each year.

second study, done in England, looked at the electronic medical records
of about 8,900 patients in southwest London, who are covered by that
country’s national health insurance system.

More medications, but higher readings for blacks
found black patients with high blood pressure had significantly higher
readings than white or Asian patients, even though blacks were
prescribed more medications.

researchers also looked at patients who were sick with one or more
conditions like heart disease, kidney disease and diabetes. They found
that blood pressure control was much worse in blacks than whites.

Patients’ failure to regularly take their
medicine may be one factor. Another may be that certain medications
work better for blacks, but some doctors may be overlooking that
difference, said Millett, a consultant in public health for Imperial

U.S. Surgeon General Dr. David Satcher said changes need to be made to
make sure minority patients can get good medical care when they need
it. But there also needs to be more done to make sure patients
understand medical directions and feel comfortable asking questions
when they don’t.

very clear we need to target our efforts to differences in” how well
patients follow medical advice, said Satcher, who is now an
administrator at Atlanta’s Morehouse School of Medicine.

Source: MSNBC

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