Managing High Blood Pressure

While still in its first year of existence, the Institute has taken aim at hypertension, or high blood pressure.

Hypertension is an insidious form of cardiovascular disease that often goes untreated for years because its victims have few, if any, symptoms. While it remains mostly silent, it wreaks havoc on the person’s overall health, doing damage that leads to stroke, heart attack, heart failure and kidney failure.

Hypertension takes its greatest toll on the poor and those of African-American and Hispanic decent. In Washington, DC, 60 percent of the city’s population is African American and 8 percent are Hispanic or Latino. It is also known that the prevalence of high blood pressure in African Americans in the United States is among the highest in the world. Compared with whites, African Americans develop high blood pressure earlier in life and their average blood pressures are much higher. As a result, compared with whites, African Americans have a 1.3 times greater rate of nonfatal stroke, a 1.8 times greater rate of fatal stroke, a 1.5 times greater rate of heart disease death and a 4.2 times greater rate of end-stage kidney disease.

To reach the target population, the Institute has partnered with Unity Heath Care, a DC-based healthcare provider that has medical facilities throughout Washington, DC, and serves individuals and families in all of the city’s eight Wards. The Institute is donating home blood pressure monitors to hypertensive patients as well as the follow-up services of a nurse.

A major goal of this program is to teach patients how to monitor and control their blood pressure. While the Institute’s primary objective with this program is community outreach, there is also an important interface with the Institute’s research goals. Researchers from GW will measure the impact of nurse-led telephone intervention with patients versus the effect of having an at-home monitor alone. Based on their findings, the program may be expanded in Washington, DC, and may even serve as a model for community outreach in other urban areas.

This community outreach program also has the potential for changing health policy. If having a home monitor and/or nurse follow-up proves to be a cost-effective means to improve the cardiovascular health of low-income patients, then the Institute will work with health policy experts from GW’s Department of Health Policy to improve access to these forms of healthcare.