Washington People: Angela L. Brown
Brown has devoted her career to helping patients control their hypertension and to training medical professionals in how to care for such patients
Angela L. Brown, MD, grew up on her family’s farm in southern Arkansas. At the farm’s peak, the family and its crew cultivated 1,500 acres of cotton, rice and soybeans and managed more than 120 head of cattle. Watching her grandparents persevere through the demands of farm life, and her parents balance their careers — her mother was a high school business teacher, and her father worked in construction — Brown learned the values of hard work and an “anything is possible” mindset.
The farm operation began in the 1920s, when her maternal grandfather inherited 20 acres of farmland. Growing up on the farm, and because Brown and her mother were both only children, Brown’s maternal grandparents played a large role in shaping the person she has become.
“My grandfather and I were very close,” Brown said. “My parents and grandparents were always of the mindset that you can accomplish anything. But my grandfather, in particular, was a risk-taking type of person. He taught me, ‘You can be successful in anything you choose, you just have to step out there and be daring.’”
Indeed, it was Brown’s grandfather who taught her how to drive trucks as soon as she could see over the steering wheel and tractors once her legs were long enough to operate the clutch and brakes. And when Brown attended elementary school in the largest town nearby, still a 16-mile drive, her grandfather let her drive the country roads on their route. They would get to the main road into town and switch places. But one day, Brown remembered, her grandfather said he thought she was doing pretty well and suggested she drive a little farther… and then a little farther.
“He actually let me drive all the way to my elementary school as a 10-year-old,” Brown said with an incredulous laugh. “When I got home that afternoon and told my mother and grandmother, they had a fit. We didn’t do it again. But that’s just the type of person my grandfather was. He was always pushing me. Telling me, ‘You can do this.’”
Clearly, these lessons stuck. Brown went on to earn a bachelor’s degree in electrical engineering from Southern Methodist University and a medical degree from Washington University. Today, Brown is an associate professor of medicine in the Cardiovascular Division at the School of Medicine and directs the Hypertension Clinic at Washington University School of Medicine in St. Louis and Barnes-Jewish Hospital.
Brown’s professional interest in treating hypertension is both practical and personal. Practical in the sense that treating high blood pressure means tackling the most common cardiovascular disease worldwide — a condition that also increases the risk of a host of other cardiovascular diseases. And personal in the sense that hypertension has affected so many members of her family.
“Managing high blood pressure is a challenge that I had experienced firsthand even before becoming a hypertension specialist,” Brown said. “My parents and grandparents all had high blood pressure. My father had heart failure and kidney failure, and died from complications of peripheral artery disease. My great grandmother and all of her siblings had high blood pressure, and they all died from complications of stroke.”
Since 2001, more than 2,500 patients have been seen in Brown’s hypertension clinic. Some come just once or twice. They’re evaluated and treated and then they return to their primary care physicians, who help them continue to manage their blood pressure. But those with hypertension deemed difficult to control — even with strong medications and changes in lifestyle — continue to come to the clinic.
Beyond seeing patients, Brown provides lectures and training to medical students, residents, fellows and primary care physicians on how to manage patients with high blood pressure. She also provides educational materials for local communities, helping spread the message about the importance of healthy eating, exercise and blood pressure screening for tracking and maintaining heart health.
Brown also is involved in research through a number of clinical trials supported by the National Institutes of Health (NIH). Her research interests have included investigating ways to prevent stroke and the development of type 2 diabetes. She also is interested in the potential for new biomedical devices to help in the management of high blood pressure. A recent study evaluated a procedure intended to lower blood pressure by altering nerve signals to the kidneys.
Brown also serves as co-director of the Center for Community Engaged Research (CCER), a part of the university’s Institute of Clinical and Translational Sciences. The group is working to help form partnerships between the School of Medicine and local communities to improve community health by increasing research participation. In particular, Brown and her colleagues are interested in encouraging better communication and interaction between School of Medicine researchers and community members of diverse races, ethnicities and social and economic backgrounds.
“Investigators have their research questions,” Brown said. “But are they the most important questions to the community? How can we have the biggest impact on community health? We may think we know the answers, but they may not be answers that are important to the community. The goal for the CCER is to have communication go both ways. To have direct community input into the research process from the beginning — from the development of the questions.”
The importance of community engagement to Brown (and her love of sports) also has led her to talk about cardiovascular health on local radio station KMOX-AM (1120) during broadcasts of Cardinals baseball games, a relationship fostered through her role as past president of the local American Heart Association Board of Directors.
“We not only need to educate physicians about hypertension, it’s important for the public to understand these health issues as well,” Brown said. “As our population ages, the prevalence of hypertension increases. And high blood pressure is a major risk factor for other cardiovascular diseases such as stroke, heart attack, heart failure and kidney failure.
“People need to get their blood pressure checked and understand what they can do to manage it — eat healthy, exercise regularly, maintain a healthy weight and, if they’re overweight, work to lose it,” she said.
When Brown is not in the clinic or performing her teaching and research duties, she loves spending time with her family and traveling (she recently returned from a trip to Cuba). Her daughter is a senior at Washington University, majoring in film and media studies with a minor in philosophy. And when Brown has the opportunity, she likes to head back to Arkansas to visit her mother, who still runs the family business. The farm is a smaller operation now — no cattle but still a respectable 700 acres. Brown views visits there as a chance to decompress — perhaps even lower the blood pressure.
“When I was a kid, I just thought it was fun growing up on a farm,” Brown said. “But as I’ve gotten older, I really appreciate the slower pace of life, one that is more connected with nature. It’s very peaceful and serene.”
“And,” she added with a laugh, “they still let me drive the tractors.”