Guest post: Advancing healthy hearts for patients

Conversations and healthy debate about issues facing our industry and the health care system are critical to addressing some of today’s challenges and opportunities. The Catalyst welcomes guest contributors, including patients, stakeholders, innovators and others, to share their perspectives and point of view. Views represented here may not be those of PhRMA, though they are no less key to a healthy dialogue on issues in health care today.

We are pleased to share a blog post from Dr. Keith C. Ferdinand, former board chair of the Association of Black Cardiologists.

Healthy Heart Month is a wonderful opportunity to refocus on the importance of controlling high blood pressure in all populations, especially African Americans. A new high blood pressure guideline from ACC/AHA and supported by the Association of Black Cardiologists (ABC) and other professional organizations, is critical to this effort.

Observational studies for adults confirm, especially in older persons, a linear, consistent and direct powerful increase in heart disease and stroke deaths with higher blood pressures. These risks increase well before the prior cut-point of 140/90 mmHg and hence hypertension is now defined as 130/80 mmHg or greater.

As part of the updated guideline, the newly defined categories of elevated blood pressure in adults will markedly increase the number of African Americans (non-Hispanic Blacks) diagnosed with hypertension, or high blood pressure, to as much as 59 percent of men and 56 percent of women in this population.

It is important to broaden awareness of this powerful and consistent risk factor for heart attack, heart failure, chronic kidney disease, end stage renal disease, peripheral vascular disease, and stroke. Recent research, along with this updated guideline, confirms the wisdom of intensive blood pressure reduction over a wide range of population, including African Americans and people ages 65 years and older, to decrease cardiovascular events or death.

There is a real, persistent, and death gap between whites and blacks in the United States,  driven primarily by poorly controlled risk factors, specifically in blacks, more prevalent and more severe hypertension. Until all populations achieve equity in terms of cardiovascular disease mortality (death rates), no one can be considered truly healthy.

Importantly, The 2018 Medicines in Development Report on Heart Disease and Stroke found that there are 200 medicines are being investigated for heart disease and stroke. Even with non-pharmacological interventions such as the DASH diet, weight control and physical activity, most patients with hypertension, especially black adults, will need two or more hypertensive medicines to  achieve BP target of less than 130/80 mmHg. Along with the addressing, the social determinants of health, such as socioeconomic status, social support, access to care, and residential environment, intensive blood pressure control with lifestyle interventions and medications are essential.

TargetBP, an ABC partner, has a wealth of information and tools to better understand how to control BP and webcast with a leading ABC member.

Keith C. Ferdinand, MD FACC, FAHA is a professor with Tulane University School of Medicine, Tulane Heart and Vascular Institute in New Orleans, Louisiana and a former board chair of the Association of Black Cardiologists.