b'A D V A N C I N G I N N O V A T I O N S I N H E A L T H C A R E P O L I C Y Q: Why are the rates for hypertension and CVDso much higher among Black adults and teens?A:The attributable risk for hypertension and 30-year, all-cause mortality is nearly double forBlacks when compared to Whites in this country. The reason why Blacks have significantly higher rates of hypertension is multifactorial and not completely understood. Genetics, diet, variability in sodium intake and retention, nocturnal blood pressure dipping, disparities in fat distribution, body mass index (higher in Blacks), and social factorsincluding early life stressorshave all been hypothesized.Q:What is missing from the current medicaltreatments for these disorders?A: Substandard insurance coverage, poor access to health care, and medical noncompliance are primary determinants of disparities associated with poor hypertension control. We need to better understand the early onset and rapid acceleration of vascular changes that occur in Black children and adolescentsmost hypertension studies are done in adults.Q: What do you see as the role of TM in this particular scenario?A:Accumulating evidence shows TM is associated with decreased hypertension and coronaryartery disease, decreased hospitalization rates, and improvements in other risk factors, including decreased smoking and cholesterol.TM can also reduce stress, and our Black American community has been hit the hardest by the COVID-19 pandemic. I believe teaching TM to Black Americans would improve the trust in the medical community that is so vitally needed.Q:How important is this proposed large-scalestudy on TM for Blacks with heart disease?A:There are already 12 published Phase 2 trials on TM and heart disease. We need a Phase 3trial to prove efficacy. This will enable insurance companies andMedicare to pay for it. I believe this will be a cost-effective strategy and will improve the lives of the participants.49'