But it’s not only because he is an interventional cardiologist in an underserved urban area of Kansas City; or because he mourns the loss of his mother to a stroke.
It’s also because he is African-American.
High blood pressure, also known as hypertension or HBP, is a direct link to heart disease and stroke, the No. 1 and No. 4 causes of death in the United States. African-Americans are disproportionately affected, with the highest rates of hypertension in the world.
Among non-Hispanic blacks age 20 and older, 43 percent of men and 47 percent of women have HBP. That’s compared with 30 percent and 27 percent of white men and women.
Meanwhile, blacks have a risk of first-ever stroke that is almost twice that of whites.
“My story is not very different than that of many others,” said Dr. Lawrence, whose mother died in September after a massive stroke. “If you are African-American, you likely have relatives who have hypertension. You likely have relatives who have had strokes caused by hypertension. It’s true of so many of the people with whom I went to high school … A couple of my closest friends have limps related to stroke.”
It’s what drives him to make a broader impact on HBP, often called “the silent killer” because of its often undetected damage to the heart.
“I have a desire to have a bigger impact, in the way you sometimes feel you can’t as an individual clinician,” he said. “I open up blocked arteries; I save patients one at a time. But if you can get to them 10 years earlier, get them to control their blood pressure, their diet, and their exercise… and create the tools and policies that allow other individual clinicians to better treat hypertension, you can have that impact.”
Recently, Dr. Lawrence was part of a team of doctors who authored a science advisory advocating a team approach. The team included, clinicians, insurance companies, nurse practitioners and patients. It looked to address the problem of hypertension in the U.S. An estimated 78 million people have HBP, with 75 percent of those being treated and just 53 percent having it under control.
The advisory, from the American Heart Association, the American College of Cardiology, and the Centers for Disease Control Prevention, suggests going beyond individual education programs to taking steps that create specific protocols for treating the population.
“We can do more good for more people by creating better systems of care to treat hypertension,” Dr. Lawrence said.
Individually, here are a few simple elements he says are important to control hypertension:
- Take prescribed medicine daily. “It has to be part of your life, like brushing your teeth in the morning, to get set for the day.”
- Restrict sodium to less than 1,500 mg a day. “Hypertension is driven in large part by excess salt intake,” he says. “Once you are without it for several weeks, you don’t miss it. It’s replaced with a newfound appreciation for food, and makes you go out and find other herbs and seasonings with which to cook.”
- Good diet and exercise. “Focus on the things you can eat: good quality meat, fruit and vegetables. Control when you eat and what you eat.”
Dr. Lawrence grew up in Cleveland with his registered nurse mother and a father who, when his son was 15, went into the hospital one day and never came home.
“He probably died of heart-related illness, but we are not 100 percent sure,” he said.
Dr. Lawrence remembers being with his dad at a park on a July 4th, “sitting there eating all kinds of bad things, somebody jogging by, and him exclaiming, ‘I don’t need to exercise, I go to work’. That epitomized past attitudes toward exercise. We want all people, including African-Americans, to understand the importance of diet and exercise.”
Those early family experiences, as well as a fateful lab internship at the age of 19 working with a hormone system that regulates blood pressure, propelled him on his path of medicine and as a volunteer for the AHA.
He received his medical degree from Harvard Medical School, with his internship and residency at Harvard’s Brigham and Women’s Hospital. He completed a cardiology fellowship at Johns Hopkins Hospital. Now, for more than two decades, he has focused his work in the same underserved area of Kansas City, Missouri. He is chief of cardiology at Research Medical Center and directs his practice, Midwest Heart and Vascular Associates.
In 2011, The AHA named Dr. Lawrence its national Physician of the Year. He is past president of the AHA’s Midwest Affiliate. He serves on the AHA’s national board and is the national “hypertension champion” leading the development of policies and programs relating to prevention, treatment, education, and collaborations.
He demurs when asked about his drive to make a large impact in preventing and treating hypertension.
“There’s nothing particularly unique about my story,” he said. “So many people involved in the treatment of hypertension have seen its ravages. We are influenced by its impact on friends and family. Hypertension is so ubiquitous you don’t have to look far for examples to motivate you. That’s true of heart disease in general. That’s what allows the Heart Association to thrive. There are so many stories out there.”
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