Forum Focuses on Hypertension

Health professionals and community leaders got together on Friday in Greenville to seek new strategies in the battle against what one expert called “a medical and societal emergency.”

The Evidence Academy on Hypertension was a partnership between the N.C. Translational and Clinical Sciences (TraCS) Institute at the University of North Carolina at Chapel Hill and the East Carolina Heart Institute at East Carolina University.

The event brought together researchers, clinicians, community leaders, public health officials and patients to gain a broader understanding on preventing, treating and controlling high blood pressure.

Uncontrolled hypertension can lead to cardiovascular disease, stroke and premature mortality, according to Lori Carter-Edwards, of the UNC Gillings School of Global Public Health. Certain racial and ethnic groups and the elderly are more likely to have these conditions. Other factors related to increased prevalence of hypertension include poverty, rural isolation, and lack of education, insurance coverage and access to professional health care.

Research shows that hypertension presents a greater burden in rural eastern North Carolina than other parts of the state; especially among blacks, who have a disproportionately high incidence of hypertension — 46.6 percent — and cardiovascular disease-related deaths, said Dr. Sid Smith, a physician at UNC-Chapel Hill and member of the Joint National Committee for the Detection, Treatment and Prevention of Hypertension. White people were the next-highest population group with hypertension, followed by Hispanics, whose incidences of hypertension were lowest in the east.

Between 2008-12 there were 235.7 cardiovascular disease-related deaths per 100,000 people statewide, according to the N.C. State Center for Health Statistics.

In Pitt County, where 15.4 percent of people live in poverty, there were 249.2 deaths per 100,000, or 13.5 percent higher than the statewide mark. In Greene County, where poverty is at 14.5 percent, there were 278.7 deaths, or 43 percent higher. In Beaufort County, with poverty at 16.4 percent, there were 284 deaths, or 48 percent higher. In Lenoir County, with poverty at 20 percent, the number was 319 deaths, or 83 percent higher. In Martin County, with 20.5 percent in poverty, there were 357.5 deaths, or 121.8 percent higher. In Washington County, where the poverty level is 20.8 percent, there were 381.5 deaths per 100,000 people, 145 percent higher than the state ratio.

Outreach efforts have not met all the experts’ goals, so forum participants discussed some of the obstacles to getting local residents to life healthier lifestyles and control high blood pressure.

Dr. David Collier of East Carolina University’s Brody School of Medicine moderated a discussion about ways to increase public awareness and collaboration.

Particular emphasis was placed on the role that pastors and churches play in such efforts, and how clinicians and researchers can become better connected to individuals through them.

Vickie Brown, pastor of Kingdom Empowerment Worship Center in Tarboro, spoke about her experience with hypertension. She has had diabetes since 2002 and was diagnosed with high blood pressure in early 2007.

“I was taking medication, but wasn’t taking it regularly and I wasn’t exercising or following a proper diet because I felt good and wasn’t experiencing any symptoms,” she said.

Brown became pregnant in 2008, but complications from her hypertension led to premature birth, a heart defect and then the death of her baby at 4 months of age, she said.

“I incorporate my story into our ministry so people don’t take their health for granted,” she said. “I now focus on what’s good for my health and my body.”

Evidence-based research led the joint national committee to five recommendations for managing hypertension and reducing the risk of death from heart attack and stroke, Smith said. The recommendations include weight reduction through the DASH diet, which emphasizes a balanced intake of poultry and fish, fruits and vegetables, whole grains and nuts and low-fat dairy products; reducing sodium in the diet; physical activity; moderating alcohol consumption; and quitting smoking.

One of the group’s goals is to rally people in eastern North Carolina to join the Million Hearts Campaign, a national initiative that was launched by the U.S. Department of Health and Human Services to prevent one million heart attacks and strokes by 2017. The group said eastern North Carolina’s target is to prevent 30,000 heart attacks and strokes by that time.