Elijah Saunders, ’60, is at war.
He wages it in churches, barber shops, hospitals and boardrooms. Any place, any time, he is relentless in his fight.

For nearly 40 years, Saunders has battled a condition that kills more African Americans than whites. Some victims don’t even know they are sick until it is too late. He battles hypertension, the “silent killer.” It affects roughly 38 percent of the black population compared with 29 percent of whites. Every hour, Saunders says, an African American dies from high blood pressure. “We don’t like what we see so far. The gap isn’t closing as much,” Saunders says. “Blacks go out earlier with a number of problems, but we think this is the major contributor.”

Saunders, a cardiologist, is professor of medicine and head of Maryland’s hypertension section. Over the years, he has built one of the country’s premiere hypertension programs. Although he is 72, and by all standards should be hitting golf balls or practicing his violin, Saunders continues to work to make sure the war against hypertension is being waged.

He is a member of more than a dozen organizations, including the International Society for Hypertension in Blacks, which he helped form, and a charter member of the Association of Black Cardiologists and the American Society of Hypertension. He lectures frequently, travels throughout the world, and manages to see patients three days a week.

“With his books and scholarly papers he has been a one-man army trumpeting blood pressure control,” says B. Waine Kong, PhD, JD, chief executive of the Association of Black Cardiologists in Atlanta, who worked closely with Saunders in the 1970s on groundbreaking studies on health in the African-American community. “He certainly has made a tremendous impact. He has contributed a great deal to the control of this terrible problem in this community.”

In Saunders’ eyes, there is still much work to be done to keep hypertension and its deadly impact at the forefront of America’s conscience. “I want people to remember that a very bad and important problem has not had enough attention, and the kind of attention I have been giving it for the past 35 or 40 years needs to be given by more people, and it needs to be done indefinitely,” Saunders says.

This has meant taking the fight to the streets. Saunders launched a program this year to train barbers and beauticians in Baltimore to take customers’ blood pressure measurements. The program is sponsored by CareFirst BlueCross BlueShield. “It has been doing very well,” he says.

“Some customers have been sent directly to the emergency room because their blood pressure was so high they needed immediate medical attention,” Saunders says. “You have to put a hard sell on them to get them to go,” he says. “We have picked up a number of people and BlueCross BlueShield is very, very pleased.” So pleased that Saunders’ funding grant has been extended.

Saunders became curious about hypertension several years after he graduated from medical school. He completed his internship, residency, and fellowship at Maryland, and opened a private practice in west Baltimore in 1965, becoming the first black cardiologist in Maryland. Most often he practiced at Provident Hospital, established in 1904 for blacks. “I was very, very busy,” he says. “I began to realize that in my first several years of practice that black patients with heart disease always had hypertension. In some cases hypertension had nothing to do with their heart disease.”
He conducted a literature search to study the condition and found a report that concluded that blacks had more frequent and severe cases of hypertension than whites. Despite a booming practice, Saunders thought he could do more to fight hypertension and raise awareness if he left private practice and became a faculty member at the medical school. In 1984, he was offered a position at Maryland and took it. Then, he launched his campaign against hypertension hoping to make an impact.

He raised awareness of the problem through organizations such as the American Heart Association, the largest organization in the world focused on heart disease, and the International Society for Hypertension in Blacks, which he helped form.

He was outspoken and quoted in the New York Times, Washington Post, Baltimore Sun and Associated Press. He wanted to know why blacks suffered higher incidents of hypertension. Was racism a factor? Diet? Heritage? Stress? Poverty? Access to care? Sodium?

In 1985, Saunders and Kong launched the first program in the country using barbers to take blood pressure measurements of customers. Initially, they began working with churches, but they weren’t reaching the number of African-American men they thought they should. Kong suggested heading to barber shops, a place African-American men frequented to catch up with friends and get their hair cut. The first barber shop program in the country was a success and adopted worldwide. But the initial program in Baltimore ran out of funding, according to Saunders.

Sometimes his efforts took him far afield. Saunders traveled to Birmingham, England, in 1996 to study Jamaican residents. His mission: to determine if Jamaicans in England, like African Americans, suffered from the same increased rate of hypertension. “I had this whole church of a few hundred people at my finger tips,” Saunders recalls. He concluded that Jamaicans, like African Americans, were salt sensitive, and suffered from hypertension despite living in different parts of the world.

Saunders believes he and others have made a “dent” in raising the awareness of the dangers of hypertension. “The awareness of hypertension as a silent killer definitely has increased, especially in the black community,” he says.

What’s more, the organizations he has helped start have kept the problem at the forefront of the medical community. “We are keeping the medical community honest,” Saunders says. “We make them recognize that there is this black problem that represents a tremendous disparity between blacks and whites.”

Like many of his patients, Saunders has high blood pressure, takes medication and is on a low sodium diet. But he exercises and enjoys playing golf. Married with three grown children, Saunders hasn’t yet decided when he will retire and have more time for his violin. The job keeps him busy especially since he is working to raise $2 million to ensure the long-term stability of his hypertension program he started more than 20 years ago. Also underway is an effort to establish an endowed faculty position in his name at the medical school.

In the meantime, Saunders’ battle against hypertension continues. “It needs to be on the front burner,” he says.