American Stroke Month: Time to Celebrate SMBP Program in the Bronx NYC

We’re at the corner of Third Avenue and 140th street in the Bronx, the most diverse borough in the city and the county that ranks 62 out of 62 — last in health outcomes across all New York State! To address this disparity, in 2021 the American Heart Association’s National Hypertension Control Initiative began supporting Damian Family Care Center, a federally qualified health center, serving a large Latino and Black population, by providing training and technical support to support launch of their Self-Measured Blood Pressure Monitoring (SMBP) program for their patients.

We were able to meet and interview some of the team behind the program, and a patient who has been empowered to take control of his health by managing the silent killer, high blood pressure. Michael Febre, 33, is a Bronx native who lost 100 pounds since he began participating in the SMBP program. He credits the program for helping him find a healthier, more balanced lifestyle that prioritizes blood pressure measurement, exercise and healthier food choices. Michael’s physical health gains have improved his mental health as well. He says that surviving in New York City, a city known for never sleeping, can be daunting. Regularly measuring his blood pressure helped Michael remain committed to his long-term health goals.


As Hypertension Program Manager at Damian Family Care Centers, Lysna Paul take a hands-on approach. She can teach patients how to measure their own blood pressure using a BP cuff at home. She also helps them monitor their high blood pressure by connecting to a BP tracking application on their phone. If something isn’t right or if Lysna sees a spike in a reading, she will get an alarm to call the patient to check-in on their health. This routine check-up usually ends up in her briefly counseling the patient by phone, or in case of emergency, she instructs the patient to call 9-1-1.

“I am honored to be part of the Self-Measured Blood Pressure Program here at Damian Family Care Centers and seeing the way this program has help improved the health outcomes of the participants. As a health educator, I am very grateful to be the liaison between the providers and patients”- Lysna Paul

The program was launched in November 2021 in the Bronx location, as hypertension plays a huge role in poor outcomes due to the health disparities that currently exist in the borough. The clinic participating in SMBP programming is in Mott Haven, a neighborhood  which is home to a large Latino and Black population. Seventy percent of the population who uses the Third Avenue location identified as Latino.

Along with high rates of hypertension, the Mott Haven section of The Bronx has one of the lowest socioeconomic statuses in NYC which only exacerbates the need for SMBP as round the clock care is crucial for survival.

Sadia Choudhury, Chief Quality and Compliance Officer, for Damian Family Care Centers network, oversees the SMBP initiative. She has worked closely with the staff at Damian Health to ensure that over 350 SMBP devices were distributed to eligible patients from Third Avenue clinic, with plans to expand to other clinics within their umbrella by March 2023.

“We feel very proud of this program and hope to do even better in coming days”, says Sadia Choudhury. “Our Hypertensive patients enrolled in this program have benefitted a lot. Within one and half year, we have more than 350 patients enrolled in the program. We conducted a study on 86 patients who stayed steady with program for 6 months. The number of patients whose blood pressure fell into HTN Stage 2 significantly decreased from baseline 34.9% to 24.4 % in 6 weeks and then to 17.4 % within 6 months of being into the program. At the same time, the number of patients whose blood pressure fell in controlled range increased from baseline 17.4% to 24.4% in just 6 weeks and to 31.4% within 6 months.”

Damian Family Care Centers, Inc. has 14 locations across New York State, serving nearly 11,000 patients annually, of which one-third of patients are seen in the Bronx. Damian aims to train more staff to assist and provide information regarding the SMBP program.  The team at Damian believes in the effectiveness of this program that increases access to validated blood pressure monitors and allows for round-the-clock readings, which go directly into a patient’s electronic health record (EHR). Clinical staff engage with patients on a regular basis through in-person and telemedicine visits to achieve better blood pressure control and reduce the risk factor for heart disease or stroke.

Melodie Lassalle- Clinical Assistant, iHealth helps patients overcome the barriers of language and technology access.

Peter Grisafi, President and CEO for Damian Family Care Centers Inc. says that being able to get home monitoring devices to patients free of charge and to be alerted to adverse readings and have care givers intervene immediately is lifesaving.

“Our staff have made remarkable progress in helping patients with uncontrolled hypertension, who need the care most, and who otherwise would not be able to afford this technology,” Grisafi said.

Damian’s Third Avenue Family Care Center is one of 350 health centers across the U.S. participating in the National Hypertension Control Initiative (NHCI), a three-year collaborative initiative among the U.S. Office of Minority Health (OHM), the U.S. Health Resources and Services Administration (HRSA), and the American Heart Association. NHCI aims to increase blood pressure control by working alongside clinical and community collaborators to ensure equitable access to quality healthcare and linkages to community-based support.

Dr. Ali Islam – Provider Champion for Hypertension SMBP program at Damian Family Care Centers.

All videos were recorded in March 2023.