PERSONAL HEALTH : A Crusade of the Heart : Black Churches Quietly Wage Winning War Against a Silent Killer: High Blood Pressure

On the first Sunday of every month, Mary Glover-Horton brings to church a stethoscope and an aneroid manometer, a Velcro-banded instrument for measuring arterial blood pressure. After worship, she sets up shop in the fellowship hall.

One by one, the dozen or so members of the Durant Missionary Baptist church who have been identified as hypertensive--including her mother, father and grandmother--sit down, stretch out their arms and have their blood pressure checked.

Those whose readings are within acceptable limits are praised for sticking to their regimens. Those in the danger zone are questioned: “Have you been staying off the salt? Have you been taking your medication regularly? Have you been under any unusual stress lately?”

Glover-Horton and her church were pioneers eight years ago when they set up the volunteer testing. Now they are part of one of the quiet success stories of American public health.

Spurred by growing alarm over high rates of hypertension among blacks, blood pressure control workers are joining deacons, pastors and church secretaries as regular fixtures among black congregations nationwide.

In the program involving Durant Missionary and 16 other churches in central Mississippi--a region with the highest documented rates of hypertension in the world--participants have achieved an overall 80% success rate in keeping their blood pressure under control. That compares with an average of less than 35% among all hypertension sufferers, according to the latest national figures.

“This is an idea that is exploding nationally,” said Dennis A. Frate, program director of the University of Mississippi’s Rural Health Research Program, which instituted the church project in central Mississippi and has published a free guide for churches interested in setting up similar programs.

In Washington, two dozen churches and more than 250 volunteers in the predominantly black southeast quadrant are involved in a project that has screened more than 2,300 residents since it was initiated five years ago.

In the San Francisco Bay Area, which has one of the oldest and largest high blood pressure control programs in the nation, the work among the churches in a six-county district has been so successful that the program has been expanded to include post offices, barber shops and public housing projects.

In Los Angeles, the movement appears not to have gained much ground yet. The Watts Health Foundation operates one of the few programs: weekly screening sessions by a mobile unit that goes to about half a dozen churches in the South-Central section and screens about 75 to 100 people weekly.

The local chapter of the American Heart Assn. notes, however, that most senior citizen centers in Los Angeles County screen elderly residents once a month. More than 60 million Americans of all races are estimated to suffer from high blood pressure, a major contributor to strokes, kidney failures and heart attacks.

But for reasons that still perplex health researchers, blacks are twice as likely as whites to have the disease--which is sometimes called the “silent killer” because its symptoms usually go undetected unless medically diagnosed. Moreover, blacks are dying at a rate three times greater than that of whites as a result of untreated high blood pressure.

There is no known cure, but effective treatments usually involve some combination of low-salt and low-fat diets, anti-hypertensive medication and changes in health habits, such as rest and recreation.

The problem is to keep people on their treatment regime. It is especially pronounced among blacks on the lower economic rungs, who are among the most likely candidates to have hypertension and the least likely to seek medical attention.

“This problem of non-compliance in hypertension therapy is a major contributing factor to the reason cardiovascular disease is the No. 1 cause of death in this country,” Frate said.

Peer Pressure Helps

This is where the church steps in. Next to the family, it is usually the major social institution in black neighborhoods and communities. As such, it is a place where people congregate regularly and where peer pressure easily can be brought to bear to ensure the diagnosed hypertensives stay on their treatments.

The programs require little more than the $50 cost of a stethoscope and a manometer and the half-day or so that it takes to train a volunteer. And the payoffs can be dramatic.

In central Mississippi, volunteers were chosen from each of the churches to serve as hypertension control counselors. Each was trained in measuring blood pressure and was given a basic education on therapies.

Under guidance of staff from the Rural Health Research Program, based in Goodman, volunteers screened their congregations to identify members with hypertension. From then on, periodic monitoring sessions--usually scheduled once a month after religious services in most churches--were all that basically was required to keep the programs going.

“I’ve gotten to the point where I can tell when a person’s pressure is up sometimes just by looking at them,” Glover-Horton said. “Their ankles may be swollen or their eyes may be puffy.”

If any of her charges misses a session, she checks up on them during the week.

Frate said that the unusual effectiveness of church-based hypertension control programs stems from just such close, personal interaction between volunteers and church members.

“People need support to get through their therapy,” he said. “That’s what the church provides. It’s really a simple form of what I call sophisticated nagging. . . .

“In many churches, there also is a sense of competition among members who are hypertensive, and they get on each other about staying on their medication and getting their blood pressure checked regularly.”

Almost All Cases

Frate said that, if it has not advanced to a critical stage, hypertension ordinarily can be brought under control in almost all cases.

When it was pointed out to one hypertension victim in the central Mississippi project that she was compounding the danger of her condition by cooking with bacon drippings, then adding salt to season the food, she put the bacon drippings in a container and shipped it off to her son in Chicago.