The prevalence of high blood pressure among African Americans is amongst the highest in the world.
From left, Dr. Aldo Calvo, Dr. Violet Atanasoski-McCormack and Dr. Arnoux Blanchard engage the audience at BHMC panel discussion.According to the American Heart Association, more than 40 percent of African Americans have this condition, which can lead to heart disease. Although attributable to several factors, the rates of obesity and diabetes in the same population are also contributing elements.
Included in these numbers are black Caribbean Americans.
Concerned about these statistics, Broward Health Medical Center (BHMC) in Fort Lauderdale, Florida, which serves a high number of African American and Hispanic patients, corroborates these numbers, adding that the heart disease and stroke rate among the more than 530,000 black population in Broward County is above 57 percent. BHMC has stepped up its outreach to educate the community about signs, symptoms, and treatment for cardiovascular disease.
BHMC recently held a panel discussion highlighting its strategy to stem and turn around these numbers. Among the speakers were doctors Arnoux Blanchard, Violet Atanasoski-McCormack and Aldo Calvo, specialists in interventional cardiology, congestive heart failure and coronary artery disease.
POVERTY
Dr. Calvo, a family physician, discussed the socio-economic factors affecting African American communities he works with, confirming that poverty affects health.
“Despite the genetic factors that we understand, if you can’t access the healthcare system, if you can’t afford the medications, if you don’t know your risk factors, don’t know what your numbers are, you don’t know what the signs and symptoms of stroke are, you are going to have more negative impact on your healthcare,” he explained.
An executive summary on African American men and blood pressure from the Centers for Disease Control and Prevention (CDC) underscores his point. The report states: “Low socioeconomic status is a stronger predictor of hypertension among African Americans compared to whites. Low socioeconomic status coupled with lack of health insurance can make it particularly difficult for this population to obtain adequate health care, resulting in African American men being diagnosed at later disease stages or after a serious event, and having greater difficulty keeping their blood pressure under control, once diagnosed.”
Dr. Atanasoski-McCormack, medical director of interventional cardiology at BHMC, has also seen the effects of inadequate healthcare and education.
“I tend to see the patients when they already have the disease and have been affected,” she said. “It’s sad to see that in some of these populations the first time that they see a doctor, the first time of presentation is coming into the emergency room with a heart attack… We save their lives, and improve their quality of life, but nevertheless, they have lost a lot of heart muscle, and they now have heart failure and all the things that go along with heart failure.
“…People should have at least the basic healthcare and at least know what their blood pressure is and what’s available.”
GENETICS
Dr. Atanasoski-McCormacksaid genetics plays a big part in coronary artery disease, but was quick to explain that socio-economic status, diet, lifestyle, and poverty are also risk factors. She said negative factors, such as smoking, high cholesterol, diabetes, hypertension,can be modified by lifestyle changes and medication. Shealso explained the significance of genetic predisposition.
“If you have three brothers who died from coronary artery disease in their 40s and 50s and your father did the same thing; if you had multiple family members that had coronary artery disease chances of you having it are quite high,” Dr. Atanasoski-McCormack said.
“And, even if you take care of all your risk factors, chances are you will delay the process and you may not get the disease in your 40s or 50s, but the likelihood is high.”
Dr. Blanchard, director of the BHMC’sCardiology Fellowship Program, agreed. He emphasized the importance of education and doctor-patient trust.
Dr. Blanchard insisted the network of community and family cannot be ignored when reviewing the problem.
“That patient lives in the context of a family,” he said. “That family lives in the context of a community, and the physician himself happen to live in that community.
“So, when we look at a patient, we have to understand their environment … Medicine is not just about taking pills, medicine is education.”
Along with a multidisciplinary approach to care education BHMC operates community outreach programs to educate residents about cardiovascular health and the symptoms and treatments for cardiovascular disease.
