Preventing High Blood Pressure and Promoting Longevity

THE NATIONAL HIGH BLOOD Pressure Education Program (NHBPEP), established in 1972, is a cooperative effort among professional and voluntary health agencies, state health departments, and many community groups. The NHBPEP is administered and coordinated by the National Heart, Lung, and Blood Institute of the National Institutes of Health. The goal of the program is to reduce death and disability related to high blood pressure through programs of professional, patient, and public education.¹ This colorful poster, produced by the NHBPEP, effectively targets the Chinese American population. The Chinese character (longevity) stands out against a red background. Red is the color of happiness in Chinese culture. The two Chinese cultural symbols of longevity and happiness and the children playing doctors, combined with the health message of the poster, communicate a sense of cultural intimacy and family joy to the audience.

Increased public knowledge of the relationship of high blood pressure to stroke and heart disease demonstrates the effectiveness of the high blood pressure education program. In 1972, less than one quarter of the American population knew of this relationship, but today, more than three quarters know about it. Moreover, almost all Americans know the importance of having their blood pressure regularly measured. The age-adjusted mortality rates for stroke and coronary heart disease have declined significantly since 1972, by nearly 60% and 53% respectively.¹ Despite this progress, some fifty million people in the United States, about one in three adults, currently have high blood pressure. For Chinese Americans, high blood pressure is one of the most common health problems in their communities.

“Their Future is in Your Hands. Treat Your High Blood Pressure Every Day.” Produced by the National Heart, Lung, and Blood Institute for the National High Blood Pressure Education Program, Bethesda, MD, 1972. Source. Prints and Photographs Collection, History of Medicine Division, National Library of Medicine, Bethesda, MD.

Only limited data have been collected about this problem, in part because of Chinese Americans’ limited access to health care.² A 2004 study in Maryland indicated that 42% of Asian Americans had no health insurance or were underinsured.³ Language, cultural, and transportation barriers make it especially difficult for seniors and new immigrants to access health care. A study of Chinese Americans in San Francisco, California, found the prevalence of hypertension in 1997 was 69% and antihypertensive medication use was 41%. In those receiving antihypertensive medication, effective control was observed in only 14% of patients. In the general US population, hypertension prevalence was 29%, antihypertensive medication use was 59%, and effective blood pressure control was achieved in 31% of patients.⁴ The especially low frequency of hypertension control among the Chinese population was attributed to cultural and language barriers, limited health care access, high medication costs, and other financial and logistic problems. Both the Maryland and San Francisco studies recommended the provision of culturally sensitive bilingual providers and health educators to reduce this major health problem.

Many Asian American communities can contribute valuable assets for health education and services. In Montgomery County, Maryland, the Pan Asian Volunteer Health Clinic provides health services with the assistance of many volunteer health professionals. Chinese language newspapers and the Chinese Culture and Community Service Center provide health education, reinforcing the health information provided by the National Heart, Lung, and Blood Institute. Sampan, a New England bilingual publication, regularly carries articles discussing social and cultural factors in health disparities. Readers are informed of normal blood pressure levels and are encouraged to engage in active lifestyles and to enjoy a healthy diet with low salt intake. Working in collaboration, we can do much to improve the health of our communities.