Bring It Down is a research program that helps patients bring their high blood pressure under control and reduce their risk of stroke.
When it comes to high blood pressure, Kaiser Permanente Northern California is very good at bringing it down. Nationally, the rate of hypertension control is only 54 percent while the rate among members is about 90 percent.
In 2001, a Division of Research (DOR) study introduced a systemwide quality improvement program to increase the rates of blood pressure control. By 2011, the rate rose from 44 to 87 percent, and has continued to climb since then.
Now the DOR is targeting the 5 percent disparity that persists between black and white members through “Bring It Down,” a multipart research program focusing on hypertension control among African Americans and stroke in the young, led by Program Director Stephen Sidney, MD, MPH.
Over the past year, 170 African-American members with uncontrolled high blood pressure completed a lifestyle intervention program based on diet, regular exercise, and stress management — aided and encouraged by phone counseling and group meetings.
According to lifestyle coach Kimberly Whelan, “the program is about increasing awareness and empowering people. We give them the knowledge and the tools, but the participants set their own goals. Their success is based on their readiness and willingness to experiment with making small, gradual changes and building on that success. And sometimes a small change is simply a greater awareness.”
Helen Weaver, 66, an administrator with a demanding job, admits she was hesitant to commit to the year-long study, which included 16 counseling sessions. As it turned out, she completed all 16 sessions, lost weight, and saw her blood pressure drop. She feels the program helped her answer “why” she needed to make changes and eat healthy foods, guided her in the right direction, and helped her take small steps to reaching goals. “Going to the grocery store is so much easier now,” she observed. “I just go around the perimeter for fresh produce and lean proteins, and I’m done.”
Lafayette Hanible, 77, a retired nurse and hospital administrator, credits the program with changing his attitude toward aging. “You can’t let aging be a crutch for not making changes,” he said. “If you get into a routine and don’t add anything new to it, you can become outdated. There comes a time when you need to make some modifications.”
Hanible, who has had cardiac problems in the past and has a heart stent and pacemaker, is now working out seven days a week, reading product labels in the grocery store, scanning menus for low-salt, low-fat entrees when he dines out, and educating his children and grandchildren about the importance of eating right.
When the results of the study are compiled this summer, Principal Investigator Mai Nguyen-Huynh, MD, MAS, and the research team will learn if they made a difference in bringing blood pressure under control through lifestyle intervention. If so, said Nguyen-Huynh, “we can build these lessons into clinical care, and enhance patient satisfaction and their active participation in their own care.”
In the second part of the Bring It Down research program, Stroke in the Young, researchers are seeking to understand why stroke rates are rising in young adults, as well as why strokes happen more often in young African Americans.
Join a tweet chat with Kaiser Permanente and the American Heart Association on ethnic disparities and hypertension control at 1 p.m. Pacific Time on May 27. To attend, type #HBPLeaderChat into Twitter’s search function.