Multiple-pronged approach to identify, treat and control blood pressure
By Sandra Jordan Of the St. Louis American
For the past few months, men in St. Louis have been rolling up their sleeves and getting their blood pressure checked -not so unusual, unless you consider it is happening in a local barber shop.
While some men may hesitate to go the doctor (especially if they have no symptoms) most men do pay a visit to their favorite barber for a little grooming.
“I just think it’s a good idea, because my father has high blood pressure and my little brother has high blood pressure. I just think black men don’t go to the doctor and don’t take care of themselves and do things that are unhealthy,” said Dawn Causey, owner of Taylor Made Barber Shop. “I felt like that was a place where they were going to get it and not pay for it or stand in line and wait at the clinic. This was one place we know they are going to go.”
Hypertension, commonly known as high blood pressure is a prevalent killer of African Americans. It creeps in silently and goes primarily undetected until it damages blood vessels, internal organs or causes a heart attack, stroke or kidney failure.
The National Heart, Lung and Blood Institute of the National Institutes of Health estimates that 65 million Americans, nearly one in three adults have high blood pressure. Blacks have high blood pressure two to three times more often than whites, get it at a younger age and make up are more likely to suffer organ damage. About one-third of those with high blood pressure are unaware they have it.
While there are some risk factors beyond control, such as age, ethnicity and family history – eating habits, fitness, weight and stress are behaviors that can be changed to stabilize blood pressure.
Chances for developing high blood pressure increases with age, however it is occurring in young black adults at earlier ages and can occur in children.
“Between the ages of 17 and 44, black men have the highest rates of detected hypertension,” said Will Ross, M.D., renal specialist at Barnes Jewish Hospital and associate professor at Washington University School of Medicine. “There is a group that has pre-hypertension. They are probably much younger.”
To improve blood pressure in this age group in St. Louis, a joint evaluative effort is underway by Washington University School of Medicine, Saint Louis University School of Public Health and other partners to educate young men about hypertension and how to make healthier lifestyle choices to avoid this silent killer.
On a busy Friday at Taylor Made Barbershop, located at 5888 Delmar not far from the University City Loop, men and women came in for haircuts and trims and received free medical advice as Dr. Ross set up a mini blood pressure clinic in the waiting area.
“You ain’t saying nothing to me Doc, talk to me,” a 49-year-old man who called himself “Little Red” anxiously asked. “We’re dropping like flies.”
Dr. Ross was listening through his stethoscope. Red’s BP was on the high side.
The doctor began probing for confounding factors that may account for the reading. Red said he worked late and eats a lot of fast food. Ross recommended that Red incorporate fruit into his diet.
“Try eating more bananas and apples or oranges,” Ross said. “If you change your diet, I believe your blood pressure will fall.
“You don’t smoke do you?” the doctor asked.
“Yes, like a chimney,” Red admitted.
Red was counseled to try to cut back or better yet quit smoking.
Ross gave each man a pamphlet called “Diabetes and High Blood Pressure – Make the Kidney Connection – What African Americans Need to Know,” and wrote his telephone number on them to follow-up. He also obtained their contact information in order to personally follow up with the ones who had high blood pressure readings.
“This is a great idea. It’s getting in touch with the inner city,” said barber Randal Foggie. He found out he had high blood pressure four years ago. “I was feeling fine and was put on meds immediately. When they said it is a silent killer -it’s true.”
Stephen Taylor’s blood pressure presented high this day as well.
“I just ate some sunflower seeds,” the 40-year-old man told the doctor.
“Sunflower seeds -they have lots of salt,” Ross reminded. “I’ll see what happens in two weeks. I’ll probably call you to see if you followed up.”
Taylor said he is making some lifestyle changes that should produce results.
“I cut down the fried foods and just finished my home gym. Now I don’t have an excuse not to exercise. I also want to set an example for my kids.”
Sir Carrawell, a 24-year-old had just stocked up on fruit at the grocery store. It will come in handy.
“He said mine should be 120 over 70,” Carrawell said. There is a history of high blood pressure in his family. He was ready to reap the harvest of eating fresh fruit with every meal.
“He said he could almost guarantee my blood pressure would drop. That’s no problem, I can do that.”
Sometimes adding fruit to the diet is not enough. One man currently on medicine learned he may need a change of prescription to control his blood pressure.
“I’ve been on the same medication a long time,” said 71-year old Jerome Bridges, who said he eats healthy and takes his meds every day.
“It’s time to make a change,” Ross said.
Men and women learned they needed to cut back on the smoking, salt and incorporate fresh fruit into their diet. Ross said the results at the barbershop were consistent with national data with five out of 11 men and women testing with high blood pressure readings.
At the Caroline Mission of Neighborhood Houses in St. Louis, three African American men meet weekly with a nurse for counseling, peer education and a blood pressure check. All have known high blood pressure, curiously all three work as cooks and all three are using what they have been learning to tackle familiar battles to keep the blood pressure in check.
“I’m exercising 30 minutes a day, five days a week,” said Arthur Chambers, 39. ‘When I came here, I made a vow to myself to do some sort of physical activity.”
After nurse Josephine Fields took Chambers’ blood pressure, she gave him “the look,” and a conversation ensued about his consistency in taking medication.
“That’s the only thing I’ve been messing up on,” Chambers said.
“I was being stubborn,” 36-year-old Antonio Harvey said. “Motivation from other peers made me become more attentive to it.” Harvey is still working on lifestyle changes.
Cedric Jenkins can count the changes he has made in his life since participating in the weekly high blood pressure programs.
“I’ve started eating a lot differently for one. I’ve started walking a lot, for two—also being aware of my salt intake.”
Each week the men fill out forms that ask probing questions to see if there are stressors or if there are changes in eating or drinking behaviors. During this visit, alcohol, hot sauce and seasoning salt turned out to be big “No-Nos.”
“We don’t know how to moderate,” Fields said. “If you’re ever going to come off hypertension meds, you’re going to have to stop. We just don’t want to adjust, but we can adjust to anything if we have to.”
Men in this program all had a previous diagnosis of high blood pressure. The program has been underway for about six months and will last two years, with an additional year of follow-up to evaluate the benefits of the program. African American men between the ages of 18-44 with known high blood pressure can participate by calling Miss Joe at Caroline House at 314-773-1107.
Know your BP
Blood pressure is the force of pressure on the walls of the arteries when blood leaves the heart with each heartbeat. Blood pressure readings involve two numbers, the systolic pressure (the top number) and diastolic pressure (the bottom number). Systolic pressure is measured when the heart is contracting to pump blood to the lungs and throughout the body. The diastolic reading is measured when the heart is relaxing between beats. Both are important in determining cardiovascular risk and blood pressure status and both are measured in by units of pressure known as millimeters of mercury, or mm Hg. A reading of 120 mmHg/80 mmHg is considered normal for adults. If your blood pressure reading is 140 over 90 or more for three or more times over an extended period, it is considered hypertension.
The only way to know if your blood pressure is elevated is to get a quick and painless check. A health professional will use a rubber cuff, a gage and a stethoscope for listening. Home blood pressure monitoring kits are sold in stores. an initial diagnosis should be made by a health professional who can advise how to treat it.
Enemies of normal blood pressure
Behaviors that negatively influence blood pressure are among unhealthy diet and activities which lead to obesity and aggravate secondary health conditions. The Processed foods are the major culprit. The American Heart Association reports most Americans get 75 percent of their sodium
Alcohol – heavy and regular consumption raises pressure to the artery walls and provides empty calories with no nutritional value.
Salt/Sodium – Reducing your daily intake of sodium in all forms helps blood pressure medicines work better and can keep blood pressure from rising in some people. Most Americans consume more than the recommended intake of all forms of sodium – 2,400 milligrams per day, which is about a level teaspoon of salt.
Fats- are hard on the heart and the blood vessels and being overweight increases blood pressure. Fat, calcium and cholesterol clings easier to damaged vessels.
Smoking – injures blood vessels and speeds up the hardening of the arteries. Smoking does not cause high blood pressure however it is an aggravator. Quitting smoking reduces a person’s overall risk of stroke and heart attack.
Lifestyle changes for better blood pressure
High blood pressure for most people can be improved by avoiding processed (canned, boxed and frozen) foods, table salt and choosing instead fresh fruits and vegetables, low fat items. Regular exercise can help reduce stress and make the arteries more pliable.
If you must eat canned foods, rinse it first. It is reported that 25-40 percent of the sodium can be removed from canned foods by rinsing them first with water before consuming.
Try not to cook with salt and highly processed, cured meats. If you must add salt, do so close to the end of the cooking process -you may use less.