A three-year Johns Hopkins study led by a nurse investigator has found that it may take a "village" to significantly lower the blood pressure of urban African-American men. "The traditional one-on-one doctor-patient visit in a doctor's office will simply not work," says lead author Martha N. Hill, Ph.D., R.N., dean of The Johns Hopkins University School of Nursing. "What our study suggests is that you need a whole team socially and culturally linked to this population, including community members as staff and a vigorous tracing method to assure compliance with the blood pressure reducing regimen."

While further research is needed to demonstrate the cost effectiveness of intense team intervention, Hill says, she suspects it will be a savvy investment. "These men tend to use a hospital emergency room for primary care," she says, "so spending the relatively low costs for intervention now should help keep these men healthier and out of expensive hospital care later."

Results of the study of 309 hypertensive African-American men ages 21 to 54 living in inner-city Baltimore, published in the November issue of the American Journal of Hypertension, also dispel the myth that underserved African-American men are hard to include in clinical trials, says Hill. "This high-risk population is vastly under-studied and typically thought to be hard to reach," says Hill, "but we found that the men cared about their health and were eager to manage their high blood pressure and to participate in the research."

High blood pressure affects one in four American adults. Among African Americans, it occurs more often, begins at an earlier age, and is usually more severe compared to whites. In addition, organ damage resulting from hypertension is higher among African Americans. In poor, urban communities, social and economic burdens often contribute to lower rates of treatment and control.

Hill and colleagues from The Johns Hopkins University School of Nursing,
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Contact: Ming Tai
mtai@jhmi.edu
410-614-5317
Johns Hopkins Medical Institutions
29-Oct-2003

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