Expert Commentary: Yan Katsnelson, M.D. 11/25/2009

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The study in the New England Journal of Medicine describes the alarmingly high incidence of heart disease in young African-American men. The article goes further implying that these figures are so high that the population is being underserved.

I think the article does not address the issue adequately. As a cardiologist, I work at The University of Chicago. Indeed we do see many young African-Americans with various degrees of cardiovascular disease, from high blood pressure to coronary artery disease to even heart attacks. I don’t think the high incidence of these problems is from lack of access. The clinics, the doctors, the treatments are there. Rather we see that these younger men who are at risk are not coming in for treatment. We must understand that high blood pressure is a difficult condition to manage. It takes constant discipline -- consistently taking your medicine, getting enough exercise, and staying on a diet. People in their 30s and 40s, not to mention those their 20s don’t seem to have that kind of discipline, as do people in their 50s and 60s.

What happens is that these patients are courting catastrophic health emergencies – like a heart attack - situations that could have been prevented with monitoring and prevention. And of course, there is a dramatic difference in costs. Responding to a medical emergency costs 5 to 10 times what preventive procedures might.

The issue I feel is not accessibility to care, it is education – getting the information out to the community – that the help is there – and more important that people should come in for checkups, even when they are young – even in their 20s -- even when they feel well. Remember high blood pressure usually has no symptoms – informing everyone to take advantage of the medical care that is available. The end result is a healthier population. And in a time when concerns for rising medical costs are generating major national debates, educational campaigns touting prevention should be seen as an effective way to control these costs.

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Expert Commentary: Yan Katsnelson, M.D. 11/25/2009

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