ASH Hypertension Community Outreach Program: taking action to address a "neglected disease".

The Institute of Medicine (IOM) panel recently declared that high blood pressure (BP) is a ‘‘neglected disease’’ that costs the US health care system $73 billion per year. 1 The IOM authors encouraged the Center for Disease Control and Prevention to promote policies to persuade Americans to exercise and consume a healthy diet to control their BP and to stimulate physicians to treat the condition more aggressively. It is time to shift the burden of hypertension prevention and treatment efforts from individuals to society, the report concluded, and to recognize that high BP has not been given appropriate attention, despite the simplicity of diagnosis, treatment, and prevention. Attacking hypertension from the aspect of public policy and systems is realistic and practical, particularly given the economic burden of suboptimal primary and secondary approaches. As noted by the IOM chair, Dr. David Fleming of the Public Health Department of Seattle and King County, Washington, individuals who live long enough are almost guaranteed to develop hypertension. 1 Thus, uncontrolled high BP should be a universal concern. Even before this landmark document and call to action, the American Society of Hypertension (ASH), the leading voice for high BP in the United States, has been committed to a comprehensive and innovative public health approach to eliminating hypertension by screening and educating high-risk individuals. During the recent 25th annual scientific sessions in New York City, ASH completed its third citywide Hypertension Community Outreach Program, continuing to raise awareness about hypertension by intervention and education at the community level. The first such program was conducted in 2008 in New Orleans, Louisiana, in conjunction with the ASH annual meeting. Overall, the ASH outreach effort builds on previous and ongoing public health programs to address hypertension at the community level, and to eliminate racial/ethnic disparities in hypertension and cardiovascular disease. One characteristic of the program is the utilization of culturally tailored interventions, such as in African American churches, barbershops, and beauty parlors. For example, the International Society on Hypertension in Blacks (ISHIB) IMPACT campaign (www.ishib.org) and the Association of Black Cardiologists (ABC) Community Health Advocates and Spirit of the Heart efforts (www.abcardio.org) are exemplary national programs using proven and unique approaches to identify and curtail high BP, heart disease, and associated risks, in addition to encouraging healthy living in a diverse America. The ISHIB and ABC initiatives aid consumers in understanding that hypertension and heart disease are preventable, can be controlled, and that heart-healthy practices are important for a long, productive life. 2 The ASH Outreach over the past 3 years has included screening and education for high-risk individuals at the community level in addition to frontline providers. Physicians, nurse practitioners, and others were educated onsite in their places of practice. During the initial effort in New Orleans in 2008, many uninsured clients were heartened to receive BP measurements, bathroom scales, home BP monitors, and basic laboratory testing, such as a lipid panel and glucose level. Importantly, ASH integrated follow-up care with local practices and centers in a struggling, post-Katrina health care landscape. The success of the purposeful and focused