High blood pressure, or hypertension, can happen to anyone—even someone who worked in healthcare. Frank Robinson, PhD, 73, was a public health practitioner at Baystate Health. He found out that he had high blood pressure during a routine primary care visit, prompted by a health screening at the Dunbar Community Center in Springfield.
HIGH BLOOD PRESSURE DIAGNOSIS
Frank knew it was important to get his blood pressure under control because of the possible risk to heart and kidney health.
“I know that dialysis and heart disease are consequences of untreated hypertension,” Frank says. He worked with Dr. Andrew Balder, his primary care provider at Mason Square Neighborhood Health Center in Springfield, to create a plan to manage his blood pressure.
“My first impression of Frank was of a patient who was committed to his health and was developing a newfound understanding of the ‘silent killer’ (hypertension),” recalls Dr. Balder. “He had a commitment to change based on interaction with male health programs in our African American community. But as with many of us, he had to develop adherence to a new lifestyle and to new medications.”
“Frank approached this diagnosis with a healthy sense of respect, not fear,” adds Dr. Balder. “He listened intently, asked questions relevant to his experience and needs and was able to gradually change [his] lifestyle and approach to medication.”
FRANK’S DAILY TREATMENT AND ROUTINE
After he was diagnosed, Frank had to figure out a treatment plan with Dr. Balder. Treatment for high blood pressure is important to lower the risk of heart disease, stroke, and kidney failure.
“Dr. Balder helped me get the right mix of treatment drugs, and the Mason Square dietician provided me with nutritional support and advice,” Frank explains. Under the care of Mason Square providers, Frank has developed a daily routine that works well for him which includes monitoring his blood pressure, along with a proper diet and exercise. Frank feels confident and comfortable in his treatment plan.
“First stop is the bathroom to get ready for the day. Take my medication first thing. I’ve recognized the importance of movement and make sure to stand up and walk around every hour on the hour. I’ve established an exercise routine – simply walking 5-10 minutes a day and daring to set up a more rigorous hour-long walk a couple times a week.”
HOW LONG DOES IT TAKE TO GET HIGH BLOOD PRESSURE UNDER CONTROL?
“It is hard to say how long it takes to control blood pressure in the ‘average’ patient,” explains Dr. Balder. “Since treatment is [a] combination of life changes, medication, each patient choosing their own path, and each care system having different degrees of capability in supporting rapid change, it may take months (or even a year) to see blood pressure change significantly. Some individuals can start one pill and do great within a month. Some have more resistant hypertension and need individually crafted plans with multiple medications and other interventions. On the behavior end, my usual approach is to expect three months of coaching to begin to see changes in one’s lifestyle.”
THE IMPACT OF RACE ON HIGH BLOOD PRESSURE
“The data has been clear for decades that hypertension has a higher prevalence and a more devastating effect on the African American community than on the white community,” explains Dr. Balder. “It is largely due to the effects of hundreds of years of marginalization in our society that we feel has resulted in secondary biologic changes, and also community stressors that influence blood pressure (and other disease processes) through social mechanisms. These include activity, diet, sleep patterns and other factors that do not change easily overnight.”
Frank wants members of the Baystate Health community to understand the root causes of high blood pressure and work to manage the blood pressure of those most at risk.
“I am speaking as a patient of the Mason Square Health Center to my fellow patients and Be Healthy Accountable Care Organizations (ACO) members, particularly Black and Brown patients with documented unmet high blood pressure needs,” he explains. “For my [former] provider colleagues at Baystate Health, please evaluate your care quality measures by race, ethnicity, and language data. Then, work to address disparities between segments for more equitable care. For all parties, understand the connection between the underlying or root causes (social, economic, and environmental factors) of chronic conditions like hypertension. Then, advocate in your community to make investments to address structural or systemic contributors to racial health disparities such as hypertension.”
TAKE IT SERIOUSLY
Frank is an advocate for monitoring your blood pressure and obtaining proper blood pressure treatment.
“Remember that high blood pressure is a threat to your health,” he says. “And if you have it, take it seriously and be sure to work with your health teams to get it in control.”
“While Frank carries an advanced degree, you do not have a PhD to engage in and succeed at your own care,” concludes Dr. Balder. “We can do this together.”
You can learn more about managing your blood pressure in our collection of blood pressure resources.