John Singleton's family urges black men to get their blood pressure checked

John Singleton's death is a reminder that black men are hit hardest by high blood pressure, a silent killer that often comes without symptoms or warning.

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By Shamard Charles, M.D.

Filmmaker John Singleton’s death is a reminder that many African American men struggle with a silent killer — hypertension.

Singleton, the 51-year-old Oscar-nominated director and screenwriter and father of seven who died on Monday, suffered from the disease, according to a statement by his family. On April 17, he suffered a massive stroke, an early and frighteningly common occurrence in young black men.

According to the Centers for Disease Control and Prevention, African American men are at greatest risk of having a stroke in the U.S. and are more likely to have a stroke at a younger age. Some reasons include higher rates of obesity and diabetes. Researchers have also found that there may be a gene that makes African Americans more salt sensitive. In people who have this gene, as little as one extra gram — half a teaspoon of salt — could raise blood pressure as much as 5 mm Hg.

“The prevalence of high blood pressure (HBP or hypertension) in African Americans in the U.S. is among the highest in the world. Almost 40 percent of African American men and women have high blood pressure. For African Americans, high blood pressure also develops earlier in life and is usually more severe,” said Dr. Carrie G. Lenneman, associate professor of cardiovascular medicine at the University of Alabama at Birmingham.

Not only does high blood pressure seem to hit black men hardest, but it underscores the difficulty in controlling blood pressure even for those who have access to top doctors.

In a statement released Monday, Singleton’s family took the opportunity to raise awareness around high blood pressure in the African American community and urged people to familiarize themselves with symptoms:

“Like many African Americans, Singleton quietly struggled with hypertension. More than 40 percent of African American men and women have high blood pressure, which also develops earlier in life and is usually more severe. His family wants to share the message with all to please recognize the symptoms by going to Heart.org,” a representative said.

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Hypertension has been making headlines. In March, the 52-year-old actor Luke Perry died of a massive stroke, and an American Heart Association report in January found that nearly half of all Americans — 121 million adults — had some form of heart disease, largely due to changes in blood pressure guidelines.

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Why high blood pressure is a ‘silent killer’

High blood pressure damages blood vessels and can lead to organ damage such as kidney and heart failure, as well as heart attacks and stroke. It’s hard to detect because it does not always cause symptoms, hence why many doctors call the disease a silent killer.

“If you are looking for a list of symptoms and signs of high blood pressure, you won’t find them,” Lenneman told NBC News. “This is because most of the time, there are none. High blood pressure is largely symptomless, thus it is important for people to know risk factors for high blood pressure like family history of high blood pressure, obesity, sleep apnea, diet and chronic kidney disease.”

Dr. Raegan Durant, an associate professor of medicine in the Division of Preventive Medicine at the University of Alabama at Birmingham, also notes that having no symptoms means that the damage is often done without warning.

“By the time individuals with hypertension begin having symptoms, it means that the cumulative effects of elevated blood pressures, often over many years, have begun to cause damage to body organs such as the eyes, brain or kidneys.”

Only a blood pressure reading by a professional can diagnose the condition.

  • Blood pressure of 120/80 or above is considered elevated
  • 130/80 to 139/89 is considered stage 1 hypertension
  • Anything 140/90 or above is considered stage 2 hypertension

If blood pressure reaches 180/120 or higher — and either number in the blood pressure reading counts — people are in hypertensive crisis, with need for immediate treatment or hospitalization.

Understanding black men and hypertension

Encouraging black men to see doctors is an important public health initiative.

Black men often don’t trust doctors, live in underserved communities with little access to doctors, and work during the hours when primary care offices are usually open.

To counter such distrust in the health care system, local initiatives such as incorporating health and wellness clinics in churches and barbershops have become more popular. Not only have these efforts helped to de-stigmatize the disease in African American communities, but it has also made it more convenient for black men to get checked. A recent study found that when black men had their blood pressure checked regularly at the barbershop their readings dropped 9 points and when a pharmacist swung by their readings went down a staggering 27 points.

Fortunately experts say that once black men know about high blood pressure, they usually do something about it, even though their hypertension remains harder to control than people in most other groups.

“Once diagnosed with hypertension, African Americans diagnosed with hypertension are just as aware of their disease and just as likely to be treated compared to whites in the U.S. Yet, African Americans receiving treatment for hypertension are often much less likely to bring their blood pressure under control,” Durant said.

How to lower heart disease risk

Regular physical activity and following plant-based diets such as DASH, a meal plan that emphasizes fruits, vegetables and whole grains, are shown to protect the heart.

“Lifestyle modification is often an untapped approach to lowering blood pressure in addition to medications,” said Durant, via email. “Of course, taking medications regularly is important, but regular monitoring of blood pressures at home, adopting a low-sodium, vegetable-rich diet, and pursuing physical activity multiple times weekly can also be helpful in lowering blood pressures.”

Not all patients have the same optimal targets, but it's important to know blood pressure, glucose, and cholesterol numbers, Lenneman added.

“It is important to know your blood pressure numbers and the new recommendations of goal blood pressures.”

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