City-wide initiative helps hypertension sufferers

UMMC program aims to reduce hypertension in African American men in Baltimore.

Bernard Clubb had been slicing vegetables for all of 10 minutes — paring a cabbage, dicing a pepper, carving up a white onion — when he grimaced theatrically and cried out in mock desperation.

"I'm going to die if I keep doing this!" he said, laughing. "I'm exhausted."

As the saying goes, old habits die hard.

Instead of just grabbing something easy, Clubb, 39, was learning to prepare a batch of cole slaw as part of a class on low-sodium, low-fat cooking — the sort of food preparation experts say can help him manage the illness he recently learned he suffers from.

Clubb, of West Baltimore, is among the more than 43 percent of African-American adults nationwide who have hypertension, a chronic medical condition in which the blood pressure in the arteries is elevated.

Though it usually presents no symptoms, hypertension increases a sufferer's likelihood of developing any of several dangerous diseases later in life, including heart failure, kidney failure and stroke.

The evening class was part of a community health initiative the University of Maryland Medical Center began offering last March.

Underwritten by a $130,000 grant from the city health department, the community outreach hypertension program aims to identify African-American men in Baltimore who suffer from hypertension, get them medical help, and offer them educational and therapeutic benefits to help them change the behaviors that likely led them to develop the disorder in the first place.

Organizers say the initiative takes aim at hypertension, or high blood pressure, on several fronts.

"Hypertension is a significant public health problem in the African-American community, and our goal is not only to help the men who participate in the program but also to educate others about [its] risks," said Anne Williams, director of the community health improvement department at the hospital.

The cause of high blood pressure is not known, but it has long been common knowledge that several behaviors are associated with it — consuming too much salt, drinking too much alcohol, being overweight, smoking and failing to get regular exercise.

The wealth of knowledge on hypertension has not prevented what might be called an epidemic of high blood pressure in the United States. About 70 million Americans — nearly a third of adults — suffer from the disorder, according to the Centers for Disease Control and Prevention.

Men and women develop it about equally, and the rates top 50 percent for both sexes after age 55.

The current grant focuses on African-American men, Williams said, because the disease affects black Americans at a significantly higher rate than any other group, and research shows that men are far less likely than women to seek preventive health care.

That, she said, makes African-American men a "high-probability" group and one worth studying in their own right.

The program employs one full-time paid staffer, community health advocate Asunta Henry, and partners with the American Heart Association, Chase Brexton Health Care and other nonprofit organizations to offer free blood pressure screenings at churches, senior centers and malls.

Those diagnosed with hypertension — if the top number in their blood-pressure reading exceeds 140 — are given a referral to an affordable health care provider.

If they show up, they become eligible to receive an array of free benefits — one-on-one counseling, home monitoring devices, access to the cooking classes, educational tours of grocery stores, even a one-year membership to the Druid Hill YMCA.

Perks like those greatly increase the likelihood of a patient's improvement, said Dr. Wallace R. Johnson Jr., an assistant professor of medicine at the University of Maryland School of Medicine who specializes in hypertension.

Johnson, who said he wasn't familiar with the initiative, said studies he has helped conduct in Baltimore showed that patients who received direct, one-on-one intervention regarding their illness — and not just advice or information — improved most quickly.

"When we did patient-directed activities, we had more of a reduction in blood pressure," Johnson said. "Patient intervention was the driver of the train."

Williams said 415 men are taking part in at least one of the program's elements.

The gym membership, valued at more than $700, has proved one of the most popular. About 20 have signed up for that since it became available in July.

Count Clubb and Dennis Hayes, 64, of Sandtown, among them.

"When I heard about that [benefit], I was in," Hayes said during the Tuesday night cooking class as he pared a jalapeno pepper. "I'm usually pretty fitness-conscious, but what an opportunity. I've been working out every other day."

Clubb, who said he eats too much fast food, drinks too much Mountain Dew and rarely gets a chance to exercise, also leaped at that chance.

"I haven't started yet, but when I go, I'm going to run to the gym for my workouts," he said.

Both later learned about the cooking class.

The session took place in the "Simple Cooking With Heart Kitchen," a facility on the campus of Stratford University that is leased and run by the American Heart Association.

"On average, Americans eat more than 3400 milligrams of sodium daily — more than double the American Heart Association's recommended limit of 1500 milligrams," one poster on the wall reads.

Sixty-five percent of that salt, it continued, comes from "food bought in retail stores."

A handful of students sat at the kitchen counters and followed instructions from heart association chef Tia Berry.

She led the students through two heart-healthy recipes — one for an Asian cole slaw (no mayonnaise) and one for a low-fat chili dish — teaching such basics along the way as how to hold a knife properly (pinch the handle), how to slice cucumbers and garlic for maximum color, flavor and nutritional effect, and how to bring flavor to dishes without using familiar but fatty ingredients such as mayonnaise and processed cheese.

Clubb and Hayes both made a show of how hard it was to give up their less-than-healthy ways.

"Cole slaw without mayo — are you trying to kill me?" Clubb asked Berry.

"Man, I'm going to go home and thaw some tacos later on," Hayes joked.

By evening's end, Hayes agreed the cole slaw was "surprisingly tasty" and said he planned to "have the boys over for some chili."

Clubb found the class so much fun he said he wouldn't miss the next one two weeks later.

But that didn't mean he'd committed to a total makeover — not yet, anyway.

"I hear it's going to be tilapia," he said, "but we're not making tartar sauce or cocktail sauce on the side. We're making strawberry-kiwi salsa. I know Tia here wouldn't steer me wrong, but I'm asking you, man, what kind of topping is that for a fish?"

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