Simple steps, compassion can help turn around lives Hypertension study tracks 300 black men

November 10, 1998|By Diana K. Sugg | Diana K. Sugg,SUN STAFF

They didn't have jobs or health insurance. Maybe worse, these East Baltimore men felt as if they didn't have anyone to talk to. What most of them didn't realize was that their blood pressure was as out of control as their lives.

But a study released yesterday at the American Heart Association's annual meeting in Dallas has proved that simple steps, and some compassion, can turn around the lives of men whom society has written off.

"Actually, it's the fact that somebody cares about them," said Mary Roary, the project's director at the Johns Hopkins' Center for Nursing Research.

The two-year study tracked about 300 African-American men, ages 18 through 54, in East Baltimore. Instead of high school diplomas, many had prison records. Some struggled with drugs and alcohol. Many didn't think they could control their lives. All these factors contributed to their high blood pressure, researchers said.

Hopkins staffers got the men appointments with physicians who gave them free blood-pressure medication. They also sent in a nonjudgmental health worker, a kind of all-purpose helper, to get the men into drug treatment, type up their resumes or talk with them about their troubles. The workers designated a family member or someone close to the patient as a support person, tutoring the patients to take their medicine, or reminding them to stop eating junk food.

One by one, about half the men got their blood pressure under control. The study also found that their emergency room visits dropped by 75 percent.

"This is about dealing with every single problem that we have," said Calvin Mayo, 50, an East Baltimore man enrolled in the program. He was diagnosed with hypertension four years ago. "I knew it was serious, but I didn't know where to turn. I didn't know what to do. If it hadn't been for that program, I might have had a stroke."

The idea of sending outreach workers into the community is centuries old. But until now, experts say, this concept has rarely been tried in a population of hypertensive young black men, a vulnerable group that often doesn't have primary-care doctors or links to other supports.

Some of state's highest rates

These East Baltimore residents post some of Maryland's highest rates for fatal conditions that stem from hypertension. According to state figures, their rate of heart disease death is double the Maryland average. Their rate of deaths from diabetes and stroke are roughly four times the state average.

"Hopkins is considered No. 1, but it's hard to say that when the community around them is dying from diseases, some of them preventable," Roary said. "This program is a nice way for Hopkins to kind of give back."

The Hopkins group wants to expand the study to include more drug treatment and employment services. It is also working to analyze whether the experiment would be cost-effective on FTC larger scale. Other cities see the Hopkins project as a model and are interested in duplicating it.

"If it turns out to be something that can be transferred to other areas, it would be extremely important," said Dr. Jeffrey Cutler, director of clinical applications and prevention at the National Heart, Lung and Blood Institute.

Since many hypertension patients who start out with good intentions may not stay on the medicine, staffers following up with patients is key, said Dr. Wallace Johnson Jr., an assistant clinical professor of medicine at the University of Maryland School of Medicine.

Recruited from ER

At Hopkins, Roary recruited the men from the emergency room, where they get their health care. At first, the patients thought they would be nothing more than guinea pigs. Others didn't believe their lives could improve.

"They said, 'It doesn't matter what I do, I'm going to die. I can take my pill, but if I walk out of the house, I may get shot or hit by a car, or I may get AIDS,' " said Dwyan Monroe, a community health worker. She drove the men to job interviews, talked to them about their problems, gave them her pager number. Some called her collect from jail.

Slowly, Monroe won them over, and they spread the word.

"They're really there to help you," said Cornell Brock, 52.

The East Baltimore man had been diagnosed with hypertension 10 years ago, but he never followed up on it. Now, with the support of Monroe, he's changed his diet, takes his medication and is looking for a job. "This thing is for real," Brock said, "and I could feel a difference in my body."

Mark Anthony Moore, 36, who has to deal with diabetes as well as high blood pressure, said he has often been discouraged and self-conscious because of his weight.

Because of the program, he feels better. He likes being able to see doctors for his high blood pressure.

"I've been up and down. Now I'm feeling pretty good, I guess because I really have to do it now. It's urgent," Moore said. "I want to live a long life."

Pub Date: 11/10/98

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