Academic journal article Negro Educational Review

Promoting Hypertension Risk Reduction: Outcomes of an Academic-Urban Community Project Collaboration

Academic journal article Negro Educational Review

Promoting Hypertension Risk Reduction: Outcomes of an Academic-Urban Community Project Collaboration

Article excerpt

Introduction

Health disparities involving Blacks are well documented and oft repeated. Hypertension has been identified as a major reason for disproportionate loss of life among Blacks in comparison to other societal groups. Hypertension prevalence estimates for Black and White adults have been reported as 40 versus 30 percent respectively (Hicken, Lee, Morenoff, House, & Williams, 2014). Also, an excessive number of Blacks in their youth has been diagnosed with essential hypertension (Brownstein et al., 2005; Ferdinand, 1997; Peters, 2006). Based upon an empirical investigation involving an older Black cohort, Egan and his colleagues (2015) concluded Blacks tend to endure inordinate complications when hypertensive. Equally disconcerting, medical professionals have frequently noted that, on average, Blacks diagnosed with hypertension need to be prescribed numerous drugs to get their blood pressure under control (Webb & Gonzalez, 2006; Wilson & Childre, 2006). Despite decades of a disparate impact of hypertension on Blacks the trend has not ceased (Branson, Davis, & Butler, 2007; Saunders, 2008).

Various speculations concerning a persistently high prevalence of hypertension among Blacks have been discussed in the literature (Flack, 2003; Jamerson, 2004). The wide-ranging speculations have comprised the identification of plausible risk factors for hypertension purported to be specific to Blacks. The identified risks have included salt sensitivity, heritability, regular consumption of a traditional soul food diet (high in fat and sodium), stress, and other genetic and socio-cultural factors (Cooper et. al, 2000; Ashaye & Giles, 2003). Others such as Ferdinand (1997) and Saunders (2008) have suggested limited cross cultural competency extant among those treating Blacks for hypertension may have also influenced unfavorable treatment outcomes. Still, DeHaven and colleagues (2011) maintained that reducing modifiable risk factor prevalence is a prudent approach to combating devastating outcomes associated with cardiovascular health issues in Blacks and other high risk communities. They further commented that sustained modification of lifestyles that support cardiovascular risk, such as hypertension, can vastly reduce the number of deaths resulting from cardiovascular disorders.

Stress, diet, and exercise are among the modifiable risk factors noted to affect hypertension onset, morbidity, and mortality (Wilson & Childre, 2006). Many investigators have targeted one or more of the aforementioned risks via community outreach intervention or the implementation of basic research. Recently, Hicken and colleagues (2014) examined chronic stress as a significant contributor to the disparity in hypertension rates in a sample of Blacks, "Hispanics," and non-Hispanic Whites. They found that Blacks had comparatively higher stress reactions to anticipated racial discrimination which they reported yields a 4% increased likelihood of hypertension. Jones, Tucker, and Herman (2009) chose to examine various types of stress and nutrition behavior in a sample of Black women with or at risk for hypertension. They concluded that stress obstructed healthy eating behavior and led to poorer health amongst the women they studied. The need to better equip Blacks with effective stress interventions is warranted as its consequences are not exclusive to increased physiological arousal (i.e. stress) but also have important implications for diet including obesity.

Liu and colleagues (2013) examined how risks associated with insufficient exercise coupled with unhealthy dietary patterns predispose Blacks to hypertension related health problems. Underscoring the need to promote more physical activity among Blacks, Tate, Dillaway, Yarandi, Jones, and Wilson (2015) studied diet, exercise, and obesity in Black adolescents and described obesity in this population as being of epidemic proportions. Paschal, Lewis, Martin, Shipp, and Simpson (2006) note that sedentary lifestyles have been linked to hypertension and, on average, Blacks have been reported to be more sedentary than is recommended for health maintenance. …

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