The NMA Announces Support Of Blood Pressure Assessments

Nurse checking patient's blood pressure( — The National Medical Association (NMA), The Association of Black Cardiologists (ABC) and The Association of Minority Nephrologists (AOMN) today announced their unified support and adoption of a position statement supporting noninvasive assessment of central blood pressure as a means of better diagnosis and management of hypertension.

These organizations have a long history of advocacy for minority populations, and have been at the forefront on the fight to end health disparities.

According to the Centers for Disease Control and Prevention, two out of three U.S. adults with high cholesterol and half of U.S. adults with high blood pressure are not being treated effectively. In a press release issued by the CDC earlier this year, the urgency of this issue was addressed. “Although we’re making some progress, the United States is failing to prevent the leading cause of death—cardiovascular disease—despite the existence of low cost, highly effective treatments,” said Thomas R. Frieden, MD, MPH, CDC director. “We need to do a better job improving care and supporting patients to prevent avoidable illness, disability, and death.”

Cardiovascular disease, which includes hypertensive disease, is a major health concern for all populations but particularly minority patients. “There can be no doubt that hypertension is a serious epidemic, and this is especially true amongst African Americans. The rates of high blood pressure, heart disease, stroke, kidney disease and even memory deficits can all be attributed in some way to high blood pressure.

Unfortunately the problem is with diagnosis but also effective control and treatment. The use of central blood pressure monitoring will give a better view of the hypertensive patient and help our physicians make better decisions on their treatment plans,” said Cedric M. Bright, MD, an internist and president of the NMA, the nation’s oldest and largest association of African American physicians.

Central blood pressure assessment is seen as a major advance in the identification of cardiovascular risk. It also provides physicians with more comprehensive information to improve hypertension treatment and management decisions. These leading organizations believe that the measurement of central blood pressure will advance the national effort to decrease health disparities associated with hypertension.

Hypertension, commonly referred to as high blood pressure, is rampant in African Americans when compared to other populations. Hypertension in African Americans is estimated to be 50% greater than in Caucasians, but the disparity extends beyond the simple elevation of blood pressure. African Americans experience an earlier onset of hypertension, inadequate blood pressure control, increased damage to the kidneys and other vital organs, and increased comorbidities than hypertensive Caucasians. Such disparities contribute to the soaring rates of kidney disease, stroke and heart failure among African Americans. Most patients are familiar with the traditional method of measurement of blood pressure with a simple cuff around the arm.  However, the cuff measures only the blood pressure in the upper arm. The assessment of central blood pressure is more accurate and effective because it measures the pressure at the heart.

The two measurements can be very different and central blood pressure readings have been demonstrated in clinical settings to be a better indicator of the damage high pressure can cause on the heart and other organs. Further, there is a case to be made in better therapeutic management (i.e. drug therapy), as medical professionals know that certain medications have  different effects on the pressure in the arm and the heart, so central blood pressure is a better indicator of the effectiveness of drugs to reduce high blood pressure.

“We must make headway against hypertension both in diagnosis and treatment in minority populations, particularly African Americans,” said Randall Maxey, MD PhD, a physician specializing in hypertension and renal disease. “The disparity in prevalence and inadequate treatment is unacceptable and unsustainable and we are committed to addressing this health crisis. The addition of the measurement of central blood pressure in a noninvasive manner provides invaluable clinical data necessary for improved diagnosis and management.”

Given the significant public health implications, the following policy positions were adopted by these national physician organizations:

• Central blood pressure measurement is a valuable, non-invasive clinical tool in the treatment of hypertension, especially in African Americans. Central blood pressure gives valuable information to the physician and thus may lead to improved therapeutic decisions and ultimately better control of blood pressure.

• Central blood pressure should be added to the measurements utilized by physicians and other clinicians diagnosing and treating African Americans for hypertension.

The organizations encourage that central blood pressure measurement be implemented into the standard of care for the treatment of hypertension based on the physician’s decision making. Further, there should be no impediment to the physician utilizing this tool including but not limited to access, reimbursement and eligibility requirements.

“The use of central blood pressure monitoring is a great step in the advancement of effective treatment of hypertension in all Americans, but particularly those populations like African Americans, with increased rates and inadequate treatment. Our position is that we must not lose focus on the need for effective, efficient and continued progress in the treatment of hypertension with the ultimate goal of improved patient outcomes,” said Cedric M. Bright, MD. “We are very proud to have worked together with other organizations to develop this important position statement. There are many factors that contribute to health care disparities, from environmental factors to diet to lifestyle, but the ability to better manage blood pressure via central BP assessment represents an opportunity to have impact on high blood pressure.”

Tiffany Monique: Making Her Musical Weight Known

Tiffany Monique

( is Tiffany Monique? She’s a member of the three-woman troupe of backup singers for Beyonce, famously known as The Mama’s. Tiffany Monique’s newly released and second video, Anytime, centers on unrequited love between a man and a woman, but could easily be the theme of her weight loss journey and pursuit of a solo music career. The lyrics express a sentiment that if you see someone for who they truly are instead of through your own narrowed focus and judgments, you may recognize their value in your life before it is too late.

Anytime’s smooth jazz beat coupled with Tiffany’s equally brilliant vocal delivery appropriately conveys a quiet but powerful lesson in authentic love, such as the plea to “look at the whole person, because you might see that you have someone good that you are about to lose.”

With a desire to be a solo recording artist since childhood, Tiffany studied music and communications at Morgan State University in Maryland.  It was there that she began to gain weight on her 5’3” frame.

“I gained the freshman 15 lbs, and then the sophomore 15lbs, the junior and senior.  I definitely wasn’t as active in college as I was in high school, so the weight just piled on and I didn’t notice the impact as it was coming.”

While still a student at Morgan, Tiffany was asked to join a musical group with other female singers from the school.  The name of the group was On Point, and it was while with them that Tiffany, just a sophomore, experienced her first taste of the music industry image standards that would begin to define her career path.  On Point was pursuing a recording contract and company executives began making references to “ the bigger one,” Tiffany recalls, who was now weighing over 160 pounds from her pre-college weight of 105 pounds.

“I started looking around and wondering who were they were talking about?  I mean, I wasn’t the tallest one, and I definitely was not wearing plus sizes, so they could not have been referring to me. “ As it turns out they were.  In fact, Clive Davis, the founder, and head of Arista Records at the time, bluntly stated that while Tiffany had talent he felt “I did not have the image to compete with the other divas on his roster. The emphasis was fully on my image.”

The situation introduced Tiffany to a reality of how strong the impact of image is in the music industry. “Still, I admit, I was kind of a purist,” she says, acknowledging her naiveté. In spite of the music executives harsh words, “I genuinely believed I had the talent, the background and the experience, so surely these things together would assist me in furthering my career as a solo artist.”  But when Tiffany only seemed to realize opportunities as a studio singer or background singer, she questioned why she couldn’t get further as a solo artist.  “It always came back to my weight.”

One of those background opportunities turned out to be with superstar, Beyonce. She and her team were seeking high caliber singers who “would push and challenge Beyonce to sing better. “It just so happened that the three of us were big girls!”  Tiffany adds. “To this day, we have never been asked to lose weight or change anything about ourselves. I appreciated that they appreciated our talent.”

Tiffany was thrilled to perform with and learn from a major talent, but after several years of touring, and now at 235 lbs., Tiffany began to reassess her career.  “I started to analyze what made artists like Beyonce really successful?  And, if I wanted that level of success, what steps would I need to take to get there?”  Even though full-figured artists like Jill Scott, Angie Stone and Adele have “ushered in a new wave of image acceptance,” Tiffany concedes it is still an uphill battle. “Thin and sexy is still in when it comes to the music industry.”

So, although happy touring the world as one of The Mamas, Tiffany found herself growing increasingly unhappy. “I was no longer comfortable in my own skin. I had borderline high cholesterol, was pre-diabetic, and had knee issues that required physical therapy for nearly a year.  I wanted to feel as good on the outside as being in music made me feel on the inside.” Coupled with her desire to get back on track toward her personal career aspirations, Tiffany began to accept what her challenge truly was – she had to lose weight.

“Being a solo artist is really important to me.  It’s been my dream since I was a child.  And because I knew this was an accomplishment I wanted personally, I started to acknowledge how much it would help me professionally as well.”

Not being able to get the attention of music industry heads fueled her weight loss goals.  She surmised if she lost the weight for herself, “they would then have to look me in my face and confirm whether I am talented or not, and not blame the weight.”

With her weight no longer her crutch, Tiffany laid out her plan to overcome it.  She’d experienced losing weight over the years on The Adkins diet, The Master Cleanse and through other quick fix diets. “I’d gained the weight over 7 years but I wanted it gone in 7 days!”  And when the weight didn’t come off in her time period, Tiffany threw up her hands up declaring her diet of choice was not working, and comforted herself with ice cream.

“So, I had to change my mindset, and there were a couple of things that I had to accept. One, I’m not going to lose the weight overnight. And, if I really want to lose the weight and keep it off, it may take as long as it did to put it on. And two, I can’t get to my goal of 100 pounds if I don’t lose one pound.”

Reading and educating herself through online forums, Tiffany became a student of nutrition and calorie counting.  “I learned I was addicted to sugar and lots of it!  I didn’t want to totally eliminate it, but I needed to understand what kind of carbohydrates and sugars I should eat – like wheat and grains instead of cookies and candies.”

She also decided to treat her weight loss as if it were a financial budget. “If you are going shopping and you can only spend $100, you can buy a bunch of stupid things and not get as much, or you can make wise choices.”  She budgeted her 1500 calorie per day comparably.  “I can go and get ice cream and blow 1000 calories leaving 500 calories for the rest of my day, or I can have some fruits and vegetables to eat all day with calories to spare.  Once I committed my mindset to that, the weight started to come off.”

Tiffany also incorporated exercise into her regimen by walking a neighborhood park that was 2.5 miles once around.  She initially gave herself a 10 minute goal to accomplish at a comfortable pace. Ten minutes became 20, and 20 led to 30 minutes.  “Over time,” Tiffany says, “not only are you exercising more, but you are becoming consistent.  And the only way we can be successful about losing weight and keeping it off is to become consistent.”

Tiffany admits her weight loss journey has also required a lifestyle change. Because she has conditioned her kitchen at home, Tiffany says it’s not hard to commit to her program.  “I make sure that anything that is going to tempt me to eat off of plan or eat too much of is not in my kitchen.  That can include healthy foods, too.  For instance, grapes are healthy for you, but you’re not supposed to eat the whole bag!”

Maintaining her new lifestyle proved more difficult when on the road performing.  “You can’t really plan your meals.  You’ll see the lettuce (from catering) but you will also see the cookies a
nd donuts.” And with the temptation of the band or crew sharing how good something is and prompting her to try one Tiffany confesses, “I’d be lying if I told you I didn’t.” But reality would quickly set back in when she gained access to a scale and found her weight loss efforts going backward.

So Tiffany created a new weight loss tool for herself while on the road.  “My reputation and how people perceived me have always been important to me.  Because I had lost weight and people were noticing and sharing their pride, I allowed their words to motivate me to keep on my program.”

“I couldn’t let them see me eating that doughnut, so I used that as a tool. When I can’t find it in myself to be strong, I find it in the support of others.”

After an 18 month weight loss journey, Tiffany is now comfortably in a size 8 and working toward her first full-length album in her pursuit of a solo presence.  With her musical team, including producer Kevin ‘Kwiz’ Ryan, Marlin Smith and Tony “T-Ro” Carter of Digital Khaoss Productions, Tiffany is soaring as an independent artist on her and Ryan’s own independent imprint label, the Rhythm 252 Music Group.

To learn more about Tiffany Monique and her music – visit her website at where you can also follow her on Twitter and Facebook.