Heart Association appoints first nonphysician head

June 30, 1996|By Jonathan Bor | Jonathan Bor,SUN STAFF

In its 72 years of fighting the nation's leading killer disease, the American Heart Association has never had anyone but a doctor at the helm. This will change next year when Martha Hill, a nurse from the Johns Hopkins Medical Institutions, becomes president of the national organization.

Hill, a nurse practitioner who also holds a doctorate in behavioral science, was voted president-elect at a meeting last week in Atlanta. She will assume the one-year post in June 1997.

Her election makes her the first nonphysician to hold the position since the Heart Association was formed in 1924 by six New York cardiologists.

"I think it's tremendously significant," Hill said in a phone interview from Scotland, where she was addressing the International Society of Hypertension. "Physicians, of course, are trained primarily to focus on diagnosis and treatment. But I think nurses by virtue of their background and experience are more aware and familiar with issues having to do with living with illness in the home and community.

"We have also played a very prominent role in patient education -- and in strategies to promote adherence to treatment recommendations."

Hill has built a national reputation as an expert in high blood pressure, or hypertension, and is a leader in the struggle to reduce the heavy toll it takes among African-Americans.

Hypertension is often called a silent killer because its symptoms do not arise until it triggers heart attacks, strokes and kidney disease.

Hill directs several studies of hypertension among blacks, one of which focuses exclusively on young African-American men. "They are the group that is least likely to be in care," she said. "But as a general statement, they have very severe hypertension with severe complications."

While doctors may be well-schooled in treatments that can bring high blood pressure under control, she said, nurses and even lay people may be more effective in changing the psychology that keeps many people from dealing with their problem.

In one of her studies, nurse practitioners physically gave patients their bottles of medication -- rather than relying on them to get prescriptions filled -- while outreach workers counseled patients at their homes and even drove them to clinic appointments during inclement weather.

With this approach, people were more likely to bring their hypertension under control than when doctors were their only contact.

"When a doctor sits in the office and expects patients to come in, take the usual drugs and do everything they are told, the system can break down at every step," Hill said. "Many young men don't come to the doctor for care, especially for something that is asymptomatic."

To many people, following patients so closely may sound expensive and even wasteful.

"But keeping one man off dialysis for a year can save $22,000," Hill said. "That money would save the salary of an outreach worker in just one year. My argument is that you have to spend money to save money."

Hill, 52, earned her doctorate at Hopkins and eventually rose to director of Hopkins' Center for Nursing Research. An associate professor, she holds faculty appointments in the schools of nursing, medicine and public health. She is also director of the post-doctoral program at the School of Nursing.

Dr. Jan L. Breslow, the Heart Association's president, said Hill's expertise in hypertension is "very central to our mission."

The Heart Association includes 30,000 doctors, nurses and other health care professionals along with 4.2 million volunteers.

Pub Date: 6/30/96

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