ESTHER BUSH

by Michael Yonas, Dr.PH
For New Pittsburgh Courier
This month’s issue on heart disease is a continuation of the monthly series started last year, focusing on health disparities in the Pittsburgh region. The series is a partnership among the New Pittsburgh Courier, Community PARTners (a core service of the University of Pittsburgh’s Clinical and Translational Science Institute—CTSI) and the Urban League of Greater Pittsburgh. Michael Yonas, DrPH, assistant professor of family medicine at Pitt, sat down with Esther L. Bush, president and CEO of the Urban League, to talk about this month’s topic.
MY: Happy New Year, Ms. Bush! As so many people make their New Year’s resolutions to live healthier, it is a good time to point out some of the things we learned about cardiovascular disease (CVD) in this month’s segment. As with other topics we have covered in the previous segments, there seems to always be a lot that we can learn about improving our health.
EB:  Happy New Year to you as well, Michael! After reading this month’s segment, I learned that CVD is the leading cause of death for men and women in the US. CVD is a “catch-all” term for so many of the health conditions that affect our loved ones, such as hypertension (high blood pressure), high cholesterol, diabetes and lack of physical activity. As Dr. Schindler points out this month, about 50 percent of African Americans with hypertension either don’t know they have it or aren’t being treated enough to lower their blood pressure. According to the Allegheny County Health Department, 42 percent of African Americans locally have been told they have high blood pressure compared with 33 percent of Whites. As with the other topics we have covered in these segments, knowing that these disparities persist among African Americans nationally and locally is sad and frustrating.
MY:  I absolutely agree with you, Ms. Bush. Dr. Schindler had some great advice for Courier readers in his section. It’s so important for people to be honest with their physicians about their lifestyle and the treatments they are prescribed. Being informed and involved in your health care is always the key to improved outcomes.
EB:  We have so much expertise and so many CVD resources here in Pittsburgh, Michael.  I really want to encourage everyone to get more involved in understanding and improving their health by talking to their health care provider. In addition, in order to help us learn more about the potential causes and solutions to address CVD and eliminate disparities, I also encourage everyone to learn about, ask questions about and consider participating in some of the research opportunities presented in this month’s segment.

HEALTH CARE REFORM ADVOCATES--Holding a sign saying "We Love ObamaCare" supporters of health care reform rally in front of the Supreme Court in Washington, March 27, 2012, as the court continued hearing arguments on the health care law signed by President Barack Obama. (AP Photo/Charles Dharapak)

by Jen Christensen

(CNN) -- Some 50 million Americans still lack health insurance. That will change for the greater majority when the Affordable Health Care Act, or Obamacare, as it's more commonly known, rolls out over the next couple of years.

While the bulk of the law goes into place in 2014, you'll see a few changes this year. However, much of 2013 will be dedicated to health facilities and government offices getting ready for the larger changes coming down the road.

The words “cardiovascular disease” (CVD), also called heart disease, describe a range of problems, including heart failure, heart attack and stroke. It describes any abnormal function of the heart or blood vessels (heart and blood vessels carry oxygen to or from the heart). CVD is the leading cause of death for men and women in the US. Someone has a heart attack every 34 seconds. Each minute in the U.S., someone dies from a heart disease-related event. Clearly, heart disease is a serious public health issue facing all Americans.
It’s important to note that there’s a difference in how African Americans suffer from CVD compared to non-African Americans. For example, African Americans are two to three times more likely to die from CVD than Whites of any age. They have almost twice the risk of first-ever stroke compared with Whites. The annual rate of first heart attacks is also higher for African Americans than for Whites.
African Americans are affected by CVD and stroke at a higher rate than Whites in the U.S. When it comes to risk factors for CVD, often the focus is on the common risk factors, such as high blood pressure, high cholesterol, diabetes, smoking and a family history of heart disease. African Americans may be at higher risk for developing some of these risk factors, like high blood pressure or diabetes, but these differences don’t completely explain why African Americans have a higher risk for heart disease and stroke. It’s important to continue studying racial differences because there are still many questions that need to be answered.  

Hypertension is one of the most important risk factors for CVD. According to John Schindler, MD, assistant professor of medicine at the University of Pittsburgh, hypertension, or high blood pressure, is a very common problem that affects up to 70 million adults in the U.S. This means that about one in three people older than 18 has high blood pressure. High blood pressure is generally defined as an average systolic blood pressure greater than 140 mm Hg or an average diastolic blood pressure greater than 90 mm Hg. The first step in controlling high blood pressure is recognizing the problem. It is known as a “silent” disease because many people have no symptoms and aren’t aware they have the condition until after they have had a heart attack or stroke.
Unfortunately, in the African American community, hypertension usually affects people earlier in life than it does in other populations. It can also lead to worse outcomes, including kidney disease, stroke, blindness, dementia and heart disease. Recent information shows that one out of every two African Americans with the condition is currently being treated with acceptable results. But, that means that half of African Americans with hypertension either don’t know they have the condition or aren’t being treated effectively to get their blood pressure as low as it should be. In Allegheny County, the percentage of adults who were told they had high blood pressure increased from 27 percent to 33 percent between 2002 and 2009-2010. As seen in Figure 1, a significantly higher percentage of Black adults than White adults had ever been told they had high blood pressure.
What can people do to avoid conditions like CVD and hypertension? Sometimes people have risk factors that make them more likely to have CVD, such as family history, being male and being older. The first step, says Dr. Schindler, is to talk to your health care provider. If you are concerned about CVD or are actually having symptoms, talk to people who can look at your overall health and give the best advice. Treatment may involve medication. If it doesn’t, living a healthful lifestyle is always good. Dr. Schindler suggests completely cutting out tobacco use; getting daily physical exercise; eating foods that are low in fat, cholesterol and salt; maintaining a healthy weight and getting regular health screenings. Also, Dr. Schindler points out that communicating honestly with your health care provider is important. If a treatment isn’t working for you, let him/her know. If you visit your health care provider regularly, she or he can stay on top of what you need to be as healthy as possible.

SPINNING--Von Atkinson of St. Louis incorporates a couple of spin classes into his weekly exercise regime. Since July, he has lost nearly 50 pounds, was taken off blood pressure medicine and has reduced his risk of type 2 diabetes. (St. Louis American Photo/Wiley Price)

by Sandra Jordan
For New Pittsburgh Courier

(stlamerican.com)--Von Atkinson was surprised when his eye doctor changed his eyeglasses to a weaker prescription. Losing 50 pounds in five months reduced the pressure on his eyes. That was a bonus, because a few months earlier, Atkinson was shocked into the gym when his doctor told him he was a borderline diabetic.

“The doctor told me, ‘Now you need to lose weight; your blood pressure is rising a little bit.’ And he said I was borderline diabetic,” Atkinson recounted. “I said, ‘No, I can’t deal with that; taking pills or shots,’ so he said just watch what you eat and do a little more physical activity.”

That was the push he needed to get serious about regular exercise.

Rather than trying to go solo at his former fitness center, Atkinson found the camaraderie of group classes at a new club was the incentive he needed to keep coming back.

“When I first started, I said you’ve got to be crazy to think I could do this type of stuff,” Atkinson said. “They do want you to go to the best of your abilities … but they don’t want you to hurt yourself, but he doesn’t want you to be lazy.”

What really encouraged him was seeing old-timers getting it done.

“I could see some other people that I knew was older than myself; middle-age or older than a lot of the people there. And some of the people who are much larger lost weight and are losing weight,” he explained. “I said if they can do this stuff, I can too.”

Another key to his success was finding the right gymnasium to suit his personality. Although he held a membership to a gym in Clayton, Mo., Atkinson said it was the “good energy” he felt at BKM, his old friend’s gym in Florissant, Mo. that kept him motivated to continue.

“I was kind of reluctant, but I decided to give it a try and here I am. I love it,” Atkinson said. “It’s fun now. It’s not a job.”

Then Atkinson started to notice he wasn’t feeling as good. He was feeling weak because his blood pressure started dropping too low.

Because of his weight loss, Atkinson’s doctor decided the medicine was taking to control his blood pressure was no longer needed.

“I haven’t been on blood pressure pills since the first of September; last of August,” he said, which means incorporating activity quickly improved his blood pressure in about six weeks.

He had been taking HBP meds since he was 47. Now 53, and on-track health-wise, Atkinson takes no medication.

Atkinson’s weekly workout includes an hour of exercises like jumping jacks, leg lifts, kettle bells, squats, and chair exercises five or six days a week. In October, he added one hour of spin classes twice a week.

“My goal when I came to the gym, I was 247pounds and I said I wanted to get down to 200,” he said. “I’m at 197.”

At 6 feet 2 inches tall, Atkinson said people are telling him he looks just right. He plans on maintaining his weight and his exercise. He just doesn’t want that “Bobble head” look.

“My doctor is very happy where I am,” he said. “My clothes fit much better and I have to take some things to the tailor. I used to be 40 in the waist; I’m down to a 36 now.”

He said the older people are telling him not to lose too much weight – because if he gets sick, he’s going to “need something.”

Being sick is the furthest thought in Atkinson’s mind these days.

“Now I feel like I am 21 again,” Atkinson admits.

Although still a couple of weeks away from his next glucose testing, he expects his blood sugar will be in the normal range.

Reprinted from the St. Louis American