May 7 2009
Results presented today at the American Society of Hypertension's Twenty Fourth Annual Scientific Meeting (ASH 2009) reveal that hypertension is still disproportionally prevalent in African-American women living in Boston’s inner city neighborhoods, despite recent improvements in diagnostic and treatment options.
Study authors conclude that a mobile health screening method is effective in identifying and educating undiagnosed or poorly controlled hypertension populations with limited access to preventative healthcare and call for an increase in community-based interventions to reduce their risk of cardiovascular disease.
Family Van is a mobile health program of Harvard Medical School which provides health education, screening for cardiovascular risk factors, and prevention services, as well as referrals to medical and social service agencies, to an estimated 50,000 of Boston's residents. Patients do not need appointments, medical insurance or even identification. All information they receive is free of charge, and the information they share is kept private.
Between 1998 and 2008, a total of 14,885 women visited the Family Van mobile screening unit. Among them 10,147 were screened for hypertension of which 42 percent had pre-hypertension (23 percent stage I hypertension and 8 percent stage II or greater hypertension respectively). Among the women with stage I or higher blood pressure, 1,240 (38 percent) were newly diagnosed. Hypertension (stage I or higher) was more prevalent in the African-American population (60 percent) as compared to Caucasian (5 percent), Hispanic (7 percent) and Asian (1 percent) respectively. Compared with Caucasian and other races, African-American women also had higher mean systolic blood pressure.
“Overall, African-Americans in Boston are more likely than white Boston residents to die from heart disease as they have much higher rates of hypertension – the most common reversible cardiovascular disease risk factor,” said study leader, Farhan Aslam, M.D., Brigham and Women’s Hospital, Boston, MA. “The Family Van model illustrates how successful community-based interventions can be in reaching the most at-risk populations who face many barriers to adequate healthcare. Importantly, its focus on prevention gives Boston’s neediest access to healthcare that is culturally appropriate and cost-effective.”
Despite unequivocal evidence that treating hypertension decreases the risk of heart attack and stroke, only a third of patients are adequately controlled. By 2025, it is predicted that more than 1.5 billion individuals worldwide will have hypertension, accounting for up to 50 percent of heart disease risk and 75 percent of stroke risk.
“These mobile health screening programs are really a new version of the traditional doctor ‘house call.’ We are encouraged that this ‘community call’ is proving successful in Boston,” said Henry Black, M.D., president of the American Society of Hypertension. “We’re hopeful that, with the right resources, interventions similar to the Family Van can be utilized in communities across the country.”
About the American Society of Hypertension
The American Society of Hypertension (ASH) is the largest U.S. professional organization of scientific investigators and healthcare professionals committed to eliminating hypertension and its consequences. ASH is dedicated to promoting strategies to prevent hypertension and to improving the care of patients with hypertension and associated disorders. The Society serves as a scientific forum that bridges current hypertension research with effective clinical treatment strategies for patients.