Why Hypertension Strikes Twice as Many Blacks as Whites

By Haynes, Karima A. | Ebony, September 1992 | Go to article overview

Why Hypertension Strikes Twice as Many Blacks as Whites


Haynes, Karima A., Ebony


LIKE a predator silently stalking its prey, hypertension, or high blood pressure, strikes African-Americans at alarmingly higher rates than it does Whites, prompting medical researchers to look at environmental factors like racism, stress and diet as causes for the disparity.

For reasons that are hotly debated in medical circles, hypertension, according to the American Heart Assn., strikes twice as many Blacks as Whites. African'Americans also suffer from chronic hypertension nearly five to seven times more often than Whites. And interestingly, Black Americans have much higher rates of high blood pressure than Blacks in Africa, leading researchers to believe that the stress of living in America's inner cities plays a major role in triggering high blood pressure in Blacks with a genetic predisposition to the condition.

The number of Blacks between the ages of 45 and 64 years with chronic hypertension is 366.9 per 1,000 compared to 204.2 per 1,000 among Whites in the same age group, according to a 1990 study by the National Center for Health Statistics. Some medical experts blame the hypertension disparity on the condition being passed on from generation to generation. Others say African-Americans are disproportionately exposed to urban pressures and racism. And still others surmise that it is a combination of both factors.

A strong case has been made that racism itself is a major cause of hypertension among Black Americans. "There are many environmental factors associated with high blood pressure," says Dr. Robert E Murray Jr., director of the division of medical genetics at the Howard University College of Medicine. "Because of the racism that exists in our society, people of darker pigment are discriminated against more than those who are fairer. Darker-skinned people undergo more stress because they feel powerless over their condition, particularly people in the inner city."

Dr. Clarence E. Grim of Charles R. Drew University of Medicine in Los Angeles theorizes that Black Americans are more susceptible to high blood pressure because of a sensitivity to salt inherited from some African slaves. The theory is that many slaves died on the passage from West Africa to the Americas and the Caribbean due to diarrhea and salt loss. Those slaves who carried genes that helped them to retain water and salt sin: rived the journey and subsequently passed the genes on to their descendants.

If the theory holds true, Grim asserts, some 75 percent of the cases of hypertension among Blacks could be eliminated by reducing salt intake. "The exciting thing is that we could start wiping out this disease in the Black community by changing dietary salt intake and by preseribing diuretics (drugs that reduce salt and flnid retention)," Grim points out.

Still, there is a third school of thought that says both environment and heredity cause hypertension in Blacks. Dr. Roger J. Allen of the University of Maryland at College Park recently paired 40 Black students and 40 White students who were matched for age, sex, dietary habits, physical fitness and medical history. …

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