Maryland Heart Center

Patient Success Stories

Hankins Proof that Aggressive Treatment of Hypertension in African-Americans Can Work

UM hypertension patient credits Medical Center cardiologist Elijah Saunders, M.D., with helping him to significantly lower his blood pressure and maintain it in a healthy range.

Elijah Saunders, M.D., takes his patient William Haskins' blood pressure.

William Hankins has been a patient of University of Maryland Medical Center cardiologist and world-renowned hypertension expert Elijah Saunders, M.D., for nearly 40 years, so when he found out 10 years ago that he had high blood pressure, he knew he was in good hands.

"I'm fortunate to have him as a physician," said Hankins at a recent press conference, where Saunders unveiled new guidelines for treating African-Americans with hypertension. "Despite my misdoings, he has been fighting to keep me alive for years."

Hankins, 70, is one of many African-American men suffering from high blood pressure. He is unique, however, in that he has managed to lower his blood pressure significantly and keep it in the healthy range, below 130/80 mm Hg.

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Statistics show that barely a quarter of all African-Americans who have high blood pressure have it under control. According to Saunders, Hankins' blood pressure is 120/70 mm Hg, down from 160/100 mm Hg, which is where it was when he was first diagnosed a decade ago.

The new treatment guidelines that Saunders announced at the press conference were created by the International Society on Hypertension in Blacks, an organization co-founded by Saunders. They were also published in the March 10 edition of the Archives of Internal Medicine.

Studies have shown that African-Americans get high blood pressure at younger ages than whites and die more often due to complications of the disease. Nearly 40 percent of blacks suffer from heart disease, and about 13 percent have diabetes. Both of these conditions are linked to high blood pressure.

"On average, one African-American dies from high blood pressure every hour in this country," said Saunders. "Hypertension among African-Americans, particularly older African-Americans, is so common that when someone doesn't have high blood pressure, they are the rare exception and not the rule. By the time many of my patients come to me, their systolic numbers [upper numbers] are in the 220s and 230s."

That is why Saunders and his colleagues are urging other doctors to be more vigilant in their treatment of African-American hypertension patients.

"I have been treating patients aggressively for at least five or six years and I've seen results," Saunders said. "We know this kind of treatment works and we know there are too many patients who aren't getting the care they need."

The International Society on Hypertension in Blacks recommends that:

All African-American patients with hypertension aim to lower their pressure to 130/80 mm Hg, not the currently accepted 140/90 mm Hg, particularly when they have other conditions such as diabetes, kidney or heart disease.
Doctors start out treating African-American patients with at least two medications instead of just one. One of these medications should include a diuretic since African-Americans are especially sensitive to salt and tend to retain salt.
African-American patients with diabetes and kidney disease be given ACE inhibitors and angiotensin II receptor blockers to slow the progression of kidney disease.

In addition, the group is recommending that doctors encourage their patients to exercise regularly and stick to a healthy diet rich in vegetables, fruits and fiber. Losing weight has a positive impact on blood pressure.

"Patients need to understand the importance of having an honest dialogue with their doctors," said Hankins. "Dr. Saunders is always on my case about doing the right things where my health is concerned. You have to have an open relationship because it isn't always easy to do the right thing."

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