Wednesday, Jul 17, 2002, 11:44 am EST
Younger African-Americans Being Diagnosed With Hypertension
Kansas City Star / The Boston Globe
TANYANIKA SAMUELS
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Life changed for Felicia Smith over a game of cards.
While playing cards during a lunch break, Smith noticed that her co-workers` voices were growing distant and fading into a hollow noise. Then a dull pain enveloped her arm.
Worried co-workers called for help. Later at the hospital, doctors discovered that the Grandview woman`s blood pressure had soared so high she was in danger of having a stroke.
That was two months ago. Now Smith is taking three medications to control her high blood pressure.
She is 29 years old.
"I never had high blood pressure before," said Smith. "It runs in my family, but I didn`t think young people got it. I thought I was kind of immune to it until I was 50 or 60 or so."
Kansas City area physicians are seeing more African-American patients like Smith. Young and seemingly healthy, high blood pressure is the furthest concern from their minds.
While African-Americans have long struggled with this ailment, high blood pressure seems to be making inroads into an even younger population.
According to guidelines issued Tuesday by the American Heart Association, starting at age 20 every person in the United States should be regularly evaluated for the risk of having a heart attack or stroke.
The recommendations mark the first time the group has suggested routine screenings for all patients beginning at the early stages of adulthood. The guidelines reflect an expanding body of medical evidence showing that lifestyle changes adopted when people are in their 20s and 30s can significantly alter the prospects of later developing heart disease, the nation`s No. 1 killer.
The guidelines are also a recognition that cardiovascular illness -- more often associated with middle-aged and elderly people -- can strike the young, stoked by poor diet, sedentary lifestyle and genetics.
According to the Missouri Department of Healthand Senior Services, the percentage of African-Americans in their 20s who have been diagnosed with hypertension increased from 7.5 percent in 1999 to 12.8 percent in 2001. The Kansas Department of Health and Environment was unable to provide comparable data on black residents, citing the small sampling size.
Hypertension`s growing pervasiveness among a younger generation has piqued concern among some local and state health officials.
High blood pressure, or hypertension, affects as many as 50 million people in the United States. The rate among African-Americans is among the highest in the world, with nearly one in three black Americans affected, compared with one in four white Americans.
Other high-risk groups include those with a family history of the condition; middle-aged and elderly people; the obese; women taking birth control pills; heavy drinkers; and diabetics.
About one in four people in Missouri and Kansas have been diagnosed with the condition.
Hypertension develops when the intensity of blood pushing against artery walls increases above normal levels. The higher the blood pressure, the harder the heart has to beat. Over time, this pressure can weaken heart muscle and lead to strokes, heart attacks, kidney failure and death.
A person has hypertension when his or her blood pressure is more than 140/90 mm Hg (millimeters of mercury). In 90 percent to 95 percent of cases, the cause is unknown. Hypertension often strikes without symptoms, but it is easily detectable and highly treatable.
Missouri state health officials worry that growing obesity rates among youth may carry through to adulthood and perhaps lead to even higher incidents of hypertension. A recent national study found that nearly 13 percent of the nation`s children and adolescents were considered obese or overweight. That percentage has nearly tripled since 1980.
Some of the progress made in treating certain heart problems may be slowing because of increasing obesity rates, said Diana Hawkins, manager of the Cardiovascular Health Program at the Missouri Department of Health and Senior Services.
"We`re really concerned that we have a lot of work to do," she said.
In her five years as a cardiologist at the Mid America Heart Institute at St. Luke`s Hospital, Tracy Stevens has seen patients suffering from high blood pressure grow ever younger. She knows of several people in their 20s taking as many as five medications.
"It`s clearly not an old people`s problem," Stevens said.
Hypertension contributed to LaAron Porter`s heart disease. The 25-year-old Kansas City man was suffering from congestive heart failure, and doctors had to place Porter on several medications to lower his blood pressure so that he could receive a heart transplant in May.
"It`s changed my whole lifestyle," he said. "Now I have to watch what I eat, watch my sodium intake. It`s pretty hard, but I still have to continue doing it."
Many younger people think they are somewhat immune to the condition until later in life, Stevens said. And that misperception is part of the problem.
"Awareness is not where it should be, so screening for high blood pressure is not where it should be," she said.
Many hypertension cases are diagnosed during routine visits to the doctor. But treating patients sometimes can be difficult, said John T. Miller, a cardiologist with Northland Cardiology in North Kansas City.
"Part of the challenge is trying to convince a patient with no symptoms to go on drugs," he said.
Early detection is key. If caught in time, some of the weakness in the heart muscle can be reversed, said Karl Pfuetze, a cardiologist with Midwest Cardiology Associates in Overland Park.
"If you catch it reasonably early...and it is treated properly, then the outlook can be very good," he said.
Changing lifestyle habits also can make a difference, area doctors said.
Kansas City is often listed as having high incidence of obesity and smoking -- both of which are risk factors for heart disease, Stevens said.
"Those are some statistics we need to get rid of," she said.
Stevens urged the young and old to have their blood pressure checked at least once a year, and more frequently if the levels are abnormally low or high.
In the months since she was diagnosed with high blood pressure, Smith has tried to exercise and eat healthier foods.
"I was already on a diet, and this made me stick to it," Smith said. "I want to keep my blood pressure down by working out and eating right so I can be a healthier individual."
High Blood Pressure
For more information on hypertension or high blood pressure, contact your family doctor or the Black Health Care Coalition in Kansas City at (816) 444-9600 or at (913) 362-0126. Also, you may visit
www.americanheart.org. Here are some tips for lowering your risk:
Decrease salt intake.
Exercise for 30 to 45 minutes most days of the week.
Maintain an appropriate weight.
Limit alcohol intake.
Quit smoking.
Take medications as prescribed.
Kansas City Star
African Americans and Hypertension
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