Keys to Controlling High Blood Pressure in the Black Population

Why is The Black Population at Greater Risk for This Dangerous Condition?

Nearly half (47 percent) of all U.S. adults live with hypertension, or high blood pressure, according to the Centers for Disease Control and Prevention. It’s called the “silent killer” because it can cause a heart attack, stroke or serious heart damage before people even realize they have it.

David Feldman, MD, PhD, FACC
David Feldman, MD, PhD, FACC

Yet not everyone shares the same risk for it. Research shows that the prevalence of hypertension in Black people is about 45 percent, significantly higher than in non-Hispanic whites (32 percent) and Hispanic people (30 percent). Theories for this disparity include genetics, higher rates of obesity and diabetes, and lack of access to appropriate healthcare.

“Even though we don’t all share the same risk, all of us should have the same access to medications and lifestyle changes we can make to lower our blood pressure and stop the damage hypertension can do to our hearts,” says David Feldman, MD, the new Section Chief of Advanced Heart Failure Treatment and Transplantation at Newark Beth Israel Medical Center.

Putting Research in Action

For 25 years, Dr. Feldman has conducted extensive research into healthcare disparities in cardiac care and their impact on Black communities. In 2008, he was part of a research team that conducted a study of 285 patients about hypertension and adherence to lifestyle modifications like diet and exercise that help reduce blood pressure. Of the 244 patients who responded, 57 percent were female and 43 percent were Black. Survey results showed an association between exercise and race. Most of the white survey respondents exercised regularly, while most of the Black survey respondents did not.

“Those results may be related to different income levels, as the income of Blacks surveyed was significantly lower than that of whites,” Dr. Feldman says. The research concludes that physicians should be prepared to ask patients what factors—economic and others—may limit patients’ ability to exercise and to offer potential solutions to overcome them.

One year later, Dr. Feldman was part of a research team that surveyed 28 physicians about their opinions regarding hypertension treatment. “We concluded that optimal blood pressure control requires increased physician understanding on the evaluation and management of blood pressure,” he says.

Forgoing a Healthier Path Forward

What’s needed now, Dr. Feldman says, is additional research and conversations that can help bridge the gap between Black people, hypertension and the medical community.

He aspires to host such conversations locally with diverse community members and forge relationships with groups like the Urban League of Essex County, which helps disadvantaged urban residents receive education, achieve employment and attain home ownership.

“The fact is, the healthcare system needs to do a better job of proving its trustworthiness to Black people,” Dr. Feldman says. “These community conversations can play a role in remedying that lack of trust on both sides and give us perspective that we as providers can use to make sure all patients receive equal care.”

Whoever your heart beats for, our hearts beat for you. To connect with a top cardiovascular specialist at Newark Beth Israel Medical Center, call 888-724-7123.