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Black patients have the highest rate of cardiovascular disease in the U.S. with 47% affected.
@ACCinTouch reports that by 2035, that figure may rise to 50%.
When we teach med students about hypertension in Black patients this is what they learn:
on #RacialBias in #MedEd: https://twitter.com/DrBryanLeyva/status/1334919407341023237
@ACCinTouch reports that by 2035, that figure may rise to 50%.
When we teach med students about hypertension in Black patients this is what they learn:
on #RacialBias in #MedEd: https://twitter.com/DrBryanLeyva/status/1334919407341023237
They learn that the incidence & prevalence of cardiovascular & renal complications of hypertension are greater than in other race/ethnicity group
That the adjusted relative risk of stroke, is more than twice as high in black patients compared with white patients. ( @UpToDate)
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That the adjusted relative risk of stroke, is more than twice as high in black patients compared with white patients. ( @UpToDate)
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When they ask "why?" We say its due to culture, salt intake, difference in body mass. We say "African Americans have been identified with higher rates of obesity & overweight at different age groups."
Racial Differences in Hypertension
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4108512
( @AmJMedSci)
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Racial Differences in Hypertension
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4108512
( @AmJMedSci)
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They learn that the disparity is due to lower control rates in black men as compared with white men.
"One reason for poor blood pressure control in blacks *may* be high rates of nonadherence with antihypertensive medication."
https://www.acc.org/latest-in-cardiology/articles/2018/10/14/12/42/cover-story-one-size-does-not-fit-all-sex-gender-race-and-ethnicity-in-cardiovascular-medicine#.X8xsm_yhbB4.twitter
( @ACCinTouch)
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"One reason for poor blood pressure control in blacks *may* be high rates of nonadherence with antihypertensive medication."
https://www.acc.org/latest-in-cardiology/articles/2018/10/14/12/42/cover-story-one-size-does-not-fit-all-sex-gender-race-and-ethnicity-in-cardiovascular-medicine#.X8xsm_yhbB4.twitter
( @ACCinTouch)
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We teach them that black women have higher rates of maternal & neonatal mortality, despite accounting for socioeconomic status & appropriate antenatal health
Racial Disparities Persist in Maternal Morbidity, Mortality & Infant Health https://www.ajmc.com/view/racial-disparities-persist-in-maternal-morbidity-mortality-and-infant-health via @AJMC_Journal
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Racial Disparities Persist in Maternal Morbidity, Mortality & Infant Health https://www.ajmc.com/view/racial-disparities-persist-in-maternal-morbidity-mortality-and-infant-health via @AJMC_Journal
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When they ask "why?" We tell them that the leading causes of death in Black women include cardiovascular conditions in addition to cardiomyopathy, pre-eclampsia, and eclampsia stemming from hypertensive disorders. ( @AJMC_Journal)
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They learn that Black infants make up 15% of all births in the US but count for 29% of all deaths. Because of low birth weights and being significantly more likely to be born preterm than white infants. We tell them its higher rates of air pollution and neighboorhood crime.
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But these medical problems & their complications have one cause in common:
Stress.
Constantly being in fight or flight. Constantly on high alert experiencing the effects of personally mediated, insititutionalized and internal racism.
@CamaraJones
https://www.health.state.mn.us/communities/practice/resources/equitylibrary/docs/jones-allegories.pdf
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Stress.
Constantly being in fight or flight. Constantly on high alert experiencing the effects of personally mediated, insititutionalized and internal racism.
@CamaraJones
https://www.health.state.mn.us/communities/practice/resources/equitylibrary/docs/jones-allegories.pdf
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We know the physiological effects of stress. High baseline cortisol & adrenaline levels. Leading to hypertension, vasoconstriction, depleting oxygen levels to vital organs or - gestating fetuses
Evidence as to why our White patients do not experience the same rate of perils.
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Evidence as to why our White patients do not experience the same rate of perils.
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So can we all agree to acknowledge the root causes of hypertension, cardiovascular complications & high death rates of black mothers & babies?
And may we all do our part to cease spreading ill perceptions which further perpetuate racial biases in medicine and beyond.
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And may we all do our part to cease spreading ill perceptions which further perpetuate racial biases in medicine and beyond.
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Thank you @DrBryanLeyva for sharing your lived experiences once again exposing systemic racism as a public health crisis.
Please know that the conversation is happening but it needs to be spoken about more and more. Even more important are the actions to be taken to end it.
fin
Please know that the conversation is happening but it needs to be spoken about more and more. Even more important are the actions to be taken to end it.
fin
