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HHS grant to bolster heart health awareness by Michael Baker Public Relations Bolstering MUSC’s efforts to improve cardiovascular health in South Carolina, the university received a four-year, $2.5 million grant from the Department of Health and Human Services (DHHS) to promote cardiovascular awareness, education and health. The grant functions as part of the department’s Stroke Belt Elimination Initiative, and to MUSC’s Brent Egan, M.D., professor of medicine and pharmacology, it provides an opportunity to focus on certain South Carolina populations in which stroke and cardiovascular diseases are especially prominent.  A Russian nesting doll of cardiovascular risk, the state contains areas of decreasing size that exhibit increasing rates of stroke risk.  Secretary Tommy Thompson, left, presents Dr. Brent Egan with a plaque honoring Egan's commitment to eliminating health disparities. “South Carolina has led the nation in stroke mortality since the 1930s,” Egan said. “The Lowcountry has one of the state’s higher average rates, and Charleston has an even higher rate within that subsection. The grant addresses state, regional and local concerns.” Egan and other medical professionals within Berkeley, Charleston, Orangeburg and Dorchester counties will work with community health centers, churches and neighborhood watch leaders to encourage healthier communities and positive lifestyle changes. WCSC-TV 5 also agreed to work with the initiative to encourage community health. For example, the spirituality inherent in many Southerners played a role in the initiative’s decision to collaborate with community churches. The faith-based initiatives will continue to be facilitated through partnerships with Palmetto Project’s Heart & Soul Program as well as Lighten Up and Health-E-AME, which originated at MUSC. “Churches are an extremely valuable venue for implementing health programs,” Egan said. “Many church leaders understand the importance of good health, and their credibility within the community enables them to be effective health ministers. “Overall, the commitment of the entire community really makes the initiative sail,” Egan said. “We want to provide a consistent, beneficial health message to everyone.” The first goal of the message, he added, should be to promote awareness of stroke’s risk factors.  “People with hypertension, or high blood pressure, have an elevated risk of stroke, but in South Carolina, 30 percent of hypertensive people don’t know they have a problem,” he said. “And more than 40 percent aren’t being treated for their hypertension.”  The figures are more frustrating when one considers that controlling blood pressure reduces the risk of stroke by 50 percent or more among those at highest risk. As technology advances, medication provides a typical option for combating hypertension, but Egan stresses lifestyle changes before pharmaceutical intervention. Walking at least 15 minutes a day, for example, can improve cardiovascular health greatly. “At least an hour of exercise per week cuts in half the risk of a heart attack,” he said. “That’s very doable for most people.” Changing diets can also help. Although nutrition experts have intoned the idea of healthy eating habits for years, the initiative offers a fresh, accessible view of nutrition in the form of the Dietary Approaches to Stop Hypertension (DASH) eating plan. “The term ‘diet’ carries a bad connotation for a lot of people, but DASH offers a real plan for proper nutrition,” Egan said. Rather than spouting vague ideas about proper eating, the plan provides a menu of items for a week of meals.  “It’s one thing to tell people what to eat,” he continued. “It’s another matter to give them a menu, detailing what the plan looks like in action.” Statistically, the eating plan has proven to lower blood pressure 10 to 15 millimeters. Although eating and exercise plans and community outreach speak of a statewide interest in alleviating poor cardiovascular health, the initiative’s grant actually represented the third piece of recognition that Egan and his colleagues have received in 2004.  The first came in March, when they received an award for Best Practice Model from DHHS for their efforts in maintaining a statewide blood-pressure-control network. “The network consists of a database, updated quarterly, of 100,000 hypertensive patients among 500 primary care providers,” he explained.  Using the network, primary care providers can monitor the number of hypertensive patients they serve, track the health progress of each patient, and compare their patients’ results and demographics with those of other providers across South Carolina. For example, doctors who serve many patients with diabetes can compare their patients’ blood pressure levels with other diabetic patients.  Sandwiched between the network award and the grant, Egan received a personal commendation from DHHS in July. As the project leader of the Excellence Centers to Eliminate Ethnic/Racial Disparities (EXCEED) Blood Pressure Project, his work earned special recognition for helping reduce and eliminate health disparities in minorities. Health and Human Services Secretary Tommy Thompson honored Egan during a celebration of the 40th anniversary of the Civil Rights Act, which promoted fair treatment for minorities, specifically blacks. Egan asserted that EXCEED’s work remains important nationwide, but especially in South Carolina. Even within high-risk areas of a high-risk region of a high-risk state, minorities are particularly susceptible to cardiovascular health problems.  According to Egan, blacks are nearly twice as likely to die from stroke as whites in South Carolina. Barbara Tilley, Ph.D., principal investigator of EXCEED at MUSC and chair of the Department of Biostatistics, Bioinformatics and Epidemiology, applauded Egan’s work, calling it groundbreaking. “He’s helped engage physicians statewide in the effort to eliminate health disparities,” she said. “The project addresses people of all areas, urban and rural. It’s very exciting.” For Egan, satisfaction lies not in recognition or awards, but in supporting the cardiovascular health of people in all demographics across the state.  “There are so many ways to improve cardiovascular health in South Carolina,” he concluded. “The idea enforced by EXCEED and the Stroke Belt Elimination Initiative is that it’s important to get down to the practical aspects of the issue.”   Friday, Sept. 10, 2004 Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to petersnd@musc.edu or catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Community Press at 849-1778.