Beating the Curse of HBP

Photo courtesy Living Hope Company

Actor Lamman Rucker was always good at impersonations, and that ability — encouraged by parents interested in the arts — set him on the acting path, where he has found success. He has had roles on All My Children and As the World Turns, as well as the sitcom Tyler Perry’s Meet the Browns and a movie by the same name. He has appeared in the Tyler Perry films Why Did I Get Married and Why Did I Get Married Too. This past May, he served as a spokesperson for the American Heart Association during High Blood Pressure Education Month and American Stroke Month.

His ability to impersonate has been good for his health because he has imitated his parents’ good eating and physical activity habits. This has helped him avoid high blood pressure and its side effects that plague his relatives and many other African-Americans. (See "African-Americans & HBP" below.)

"You learn what you see modeled," Rucker said. "My parents weren’t couch potatoes who just sat around and ate fast food every day." His mother, Malaya, is a dancer and still teaches dance, and his father, Eric, loved to play soccer and is a drummer in a band. Both are still active in their 60s. His maternal grandfather died before he was born, but his grandmother took nutrition seriously: "She always fed us in a very healthy way," Rucker said. "And I never saw my parents eat anything crazy. Consequently unhealthy food, like chips and chili-cheese fries, has never been a habit. That is not the kind of food that lives at my house. I’ve seen a lot of really good behavior, and I’ve modeled that."

In addition to seeing the good habits of his parents, he also saw the bad habits of his relatives and their consequences. He remembers the medicine bottles surrounding his paternal grandmother and an uncle whose face drooped due to a stroke. "I remember thinking, ‘I don’t want that to happen to me.’" At family reunions where unhealthy food was everywhere, his parents stepped in and prevented him from eating the unhealthy foods on offer.

Photo courtesy Alice Benjamin

Modeling his parents, Rucker, 43, works out regularly. He doesn’t have a set routine that he runs through at the gym. "I like to mix it up — basketball, martial arts, soccer, water aerobics, weight machines, but I always start with stretching," he said. The variety keeps it interesting.

As for food, he eats consciously and conscientiously. "I eat almost no processed food. I try to eat a lot of greens and fruits and nuts and other things that are natural, organic or low in sodium," he said.

Rucker is away from home a lot and admits that neither he nor his girlfriend do much cooking when they’re home. "We work together and encourage each other to eat well and eat smart," he said. "Our food choices are very similar because we share the same values." On set he works with the caterers to make sure he gets the right kind of food.

In his world, being thin doesn’t automatically equate to being healthy, nor does he subscribe to missing meals to lose weight. He eats six small meals each day as well as healthy snacks. "When we’re through talking, I’m going to eat some almonds and some fruit because it’s several hours till I get to my destination and can eat a meal," he said. "When my stomach starts to grumble, I grab some fruit or nuts or granola and yogurt. Don’t starve your body." He always keeps water around, never drinks soda and doesn’t eat late at night. "I try not to eat carbs and sweets within four hours of laying my body down. If I’m not going to burn it off in those four hours, then I don’t eat it."

Nor does he engage in unwholesome habits like heavy drinking, drugs or smoking. "I make sure I pay attention to my body on all its levels," he said. "Sometimes the choices we make when we want instant gratification have long-term consequences that we don’t want to live with."

Rucker has also learned to shed stress and keep control of his mind. For example, he doesn’t schedule things back to back but gives himself time to decompress between appointments. "I don’t allow myself to get out of whack," Rucker said. "I’ve learned practices and habits that keep me cool, that keep me even-keeled and levelheaded. I meditate. I visualize."

He warns people who want to change their lives by developing better habits not to go overboard. Take it gradually, especially if you haven’t been active in a while. "You’re not going to be able to undo all that you’ve done bad in that one day," he said. "That’s a recipe for injuring yourself and just delaying your transformation even longer."

Although he doesn’t have children of his own, he has many nieces, nephews and godchildren that he has helped raise. He emphasizes the importance of modeling good behavior and having fun. "I fell in love with hiking and camping not because I liked walking and sleeping on the ground but because I liked finding bugs and looking for animals," Rucker said. "Discoveries like those start with adults exposing children to things they’re not going to see playing videogames. You got to get up, get out and get involved. I take a very active and direct role in engaging in these activities with children and young people as well as allowing them to watch me do it myself. That’s how they’re going to learn to live better.

"The philosophy I teach them is simple — you have to be mindful of what you’re putting in your system. And that goes for what you put in your eyes and your ears — that’s just as important as what you put in your mouth."

Dr. Rani Whitfield

African-Americans carry a devastating distinction — they have the highest rates of high blood pressure in the world. More than 46 percent of non-Hispanic black women and 45 percent of black men have high blood pressure. (Normal BP is defined as 120/80mm Hg or lower; high BP is defined as 140/90 mm Hg or higher.) If you’re African-American, there’s a good chance that you, a relative or black friend has hypertension. Not only is HBP more common in blacks than whites, it is more severe and develops earlier in life. We talked with Rani Whitfield, a spokesperson for the American Heart Association, on this subject. Whitfield, a general practitioner in Baton Rouge, Louisiana, treats a large number of African-Americans.

"We’re not quite sure why anyone has high blood pressure," he said, "But we do know that when we find it, we need to control it. I am very aggressive in my practice about managing it."

Whitfield posited a couple of theories why blacks suffer with this condition more than others. One theory is that African-Americans have a gene that causes them to retain salt. Salt intake is closely associated with the development of HBP and this is especially the case in African-Americans.

The second theory is called ‘vessel noncompliance.’ "In this condition, the vessels are so stiff that they don’t compress easily and pressure becomes elevated," he said.

Higher rates of obesity and diabetes may also place African-Americans at greater risk for high blood pressure and heart disease. Rates of overweight and obesity for African-American men are 69.4 percent and 81.9 percent for women.

Diagnosed diabetes rates for African-American men are 13.8 percent and 14.6 percent for women; undiagnosed rates are 4.8 percent for men and 2.3 percent for women.

In addition to a high prevalence of HBP in blacks, there are also difficulties in treating it in this group. "Treatment is often complicated by the fact that some African-American patients don’t have just one problem," Whitfield said. Other conditions such as diabetes, high cholesterol and sometimes HIV may need to be managed along with HBP. That may mean more medicines and other factors must be considered as well.

Lack of education about the condition and lack of access to healthcare can also play a role. Patient education about hypertension, as part of a hypertension program, is related to improved blood pressure outcomes. Furthermore, access to care is also critical. In Whitfield’s state of Louisiana, for instance, there are 166,000 poor, nonelderly adults without insurance. "That complicates treatment because often those people have to choose between eating and buying medicine or paying the light bill," Whitfield said. Though cheap generic drugs help, patients are often taking several medications and the costs add up.

As with almost everyone else taking medication, medical adherence is a problem with African-Americans and also contributes to their high rates of HBP. Whitfield notes several barriers to patients taking their prescriptions: "First is cost; second is multiple doses. I’m big on trying to find medicine that can be taken once a day," he said. Another problem is poorer patients living in areas where there are no convenient pharmacies; some of his African-American patients may be homeless or don’t have a permanent address where medications can be sent.

Whitfield trained and works in a lower socioeconomic community and has learned to ask pointed questions, "but not all doctors are comfortable asking probing questions of their minority patients," he said. "So those patients’ needs may go unmet."


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