Hypertension Prevalence in the African American Community

Hypertension Prevalence in the African American Community 

Abstract

Hypertension (High Blood Pressure) is both common and detrimental to African-Americans than any other ethnic groups. According to the 2005–2006 National Health and Nutrition Examination Survey (NHANES) data, the current prevalence of hypertension in African-Americans is 39.1%, which is well above non-Hispanic whites at 28.5%. This disease is a current and progressive health problem contributing to significant morbidity and mortality among African Americans. With all the research and trials to help better understand the difference of Hypertension amongst Blacks and other ethnicities they still are struggling to fully control and reduce high blood pressure in the African American community. There are preventable treatments and ways to reduce chances of developing high blood pressure through lifestyle management, yet most African Americans have a low prevalence of engaging in hypertension prevention self-care behaviors. Genetic make-up, socioeconomic status, environment, obesity, smoking, and increased BP sensitivity to salt ingestion continues to be postulated as leading causes to developing hypertension (high blood pressure).   

Keywords:  Hypertension, High Blood Pressure, High Prevalence, African Americans, Detrimental, Risk Factors, Lifestyle Management.

Hypertension Prevalence in the African American Community 

Genetic factors in African Americans are main precursors to developing hypertension. Today, we are making a step towards better medicine and prevention programs to help inform the African American community about ways to reduce chances of high blood pressure and help control/manage it if already developed.  Even though this has been a known health problem amongst all ethnicities, still African Americans suffer the most and require different and more rigorous treatment. Researchers have uncovered some facts: In the U.S, blacks respond differently to high blood pressure drugs than do other groups of people. Blacks in the U.S. also seem to be more sensitive to salt, which increases the risk of developing high blood pressure. Studies and trials on hypertension in African Americans show evidence of possible differences in etiology; such as obesity. Obesity is a major contributing factor to hypertension. Genetic make-up of African descent is commonly blamed for one becoming obese. With African Americans already at a disadvantage it is our generations job to help teach and promote free and affordable health awareness/prevention programs, support groups, ways to manage the disease if already developed, and more importantly put a stop to differences of treatment due to racism. 

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African American Descent, Genetic Make-Up and Different Etiologies 

History of the African American culture is centered around the abuse and hardships they faced during the slave era. These times were very stressful and detrimental towards their health.  They were treated poorly mainly feeding off their owner’s scraps and finding new ways to make food fill the bellies of every man, woman, and child. The food they ate was very high in sodium (pork, lots of lard, salt) which can cause water retention weight in your body. Many African Americans who are interested in science today like to blame their ancestors for why they are sensitive to salt, aka survival of the fittest (genes surviving through multiple generations).  Wilson and Grimm experimentally determined the difference in the incidence of hypertension among African Americans and Africans as evidence of gene distribution. They measured the blood pressure in a West African village whose salt intake resembles that of African Americans. Hypertension rates in Africans living today in the regions where North American slaves originated are about 7 times lower than the rates for African Americans (Fackelmann, 1991). In my opinion, after researching and understanding this topic, the only difference between past and present in the African Americans is change in exercise not diet. They were forced to work strenuous jobs keeping them “healthy” and “active” allowing their bodies to consume the high sodium foods. Today, we must pay a fortune for healthy food and a decent gym to stay on track of a healthy lifestyle. Not everyone can afford a gym membership or healthy low sodium intake food. I know I for sure cannot afford that and I am a White female. The food I normally buy is the cheap 1-5$ frozen meals so I can have enough for two weeks at a time, and we all know how much sodium is in canned, frozen, meat, and soup/rice food. So yes, I do feel it is appropriate for me to say that even though we have come so far in trying to make everyone equal we still see African Americans falling victim of hypertension because of racial inequality, economic status, and the different treatment they receive.

The data in figure 1 on page 9 in my paper shows the high rates of hypertension in African Americans compared to whites from 1988 to 2010. The data is alarming, showing that even after twenty-two years of change in our world, more resources available, advance in medicine and technology, hypertension still is rising in the African American community. Studies are showing that preventative drugs used to reduce high blood pressure, prevent heart attacks and strokes, are correlated with significantly worse cardiovascular outcomes in hypertensive African Americans compared to whites, according to a new comparative study conducted by the Department of Population Health at NYU Langone Medical Center. The study, published on September 15, 2015, in the Journal of the American College of Cardiology (JACC), “is unique, the authors say, in that it evaluates racial differences in cardiovascular outcomes and mortality between hypertensive black and white patients whose treatment was initiated with angiotensin-converting-enzyme (ACE) inhibitors, outside of a clinical trial”. (NYU Langone Medical Center) Due to the worse side effects from the drugs in African Americans in this study, then looking at figure 1 (trends in hypertension) I can infer that throughout the twenty-two years it looks like the ACE inhibitor was widely prescribed by doctors who ignored ongoing research data and did not apply it in the clinical setting. This would scare anyone away from seeking medical treatment if they saw the data showing negative outcomes of African Americans health. Do not let that stop you from seeking medical help if needed, because there are still very helpful drugs out there such as; Diuretics. “The ability to cause loss of fluids in the body has made diuretics useful in the treatment of a variety of conditions, particularly excess fluid (swelling) states and hypertension”. (Jay Harold Health) Rather than focusing on medical treatment being the only option to helping prevent hypertension, let me tell you about effective and affordable ways to minimize the percent chance of high blood pressure.

Non-Medical Preventative Ways to Reduce Chances of Hypertension

 Economic status can be very stressful, especially if it affects one’s ability to live a healthy lifestyle. The media constantly talks about obesity rates and how America is very unhealthy from all the processed foods being consumed, but the government and food businesses never seem to care and switch gears in helping African Americans and all races in general to obtain healthy food. Many do not have the resources or funds to afford healthy food, so they get what they can afford; which is fast food, canned and frozen food. Instead of accepting this I decided to look into ways for low-income families to learn and adopt healthy habits and so they can teach their children and even community. During our HPP project which is the same topic I got to speak to an accountant at an OKC YMCA. YMCA which is a gym branched all throughout the U.S. is willing to work with anyone suffering financial hardships. They require the applicant to come in and pick up a membership price reduction form, fill it out, and show their tax statement proving low-income status.  YMCA said they usually grant anywhere from 10 to 60 percent off of membership fees and have in extreme circumstances granted 100 percent free of charge.  They are strong believers in everyone being able to live a healthy lifestyle no matter where they come from.  This gym provides classes, pool, gym, daycare, intramural sports and much more.  Not all YMCA’s have the same facilities, but you are allowed at any! If one still thinks it will be too much of a strain on their life, then they can do simple exercises at home and even get out and walk a little bit a day. Even going up your stairs at a home or apartment complex is a good workout! Also, drink plenty of fluids and avoid sugar intake from sodas and juice!

 Sodium, sugar, carbs, and meat are all very much enjoyable. No one wants to cut out bread forever or skip on salt creating a tasteless dish. Also, alcohol is known to cause high blood pressure, so lowering alcohol consumption greatly helps. Foods containing potassium, magnesium, and fiber, on the other hand, may help control blood pressure. “Stick to whole fruits and veggies. Juice is less helpful, because the fiber is removed. Also, nuts, seeds, legumes, lean meats, and poultry are good sources of magnesium”. (Webmd) Apples, sweet potatoes, kale, spinach, and tuna are just a few of the healthy foods to help reduce hypertension and are very affordable! Accepting etiological differences and being empowered to change an unhealthy diet to a healthy one is a great first step towards reducing your chances of high blood pressure. Willpower to want to make a change, now that is the most crucial part towards a healthy life.

Hypertension Wrap Up

  Hypertension is known as one of the highest health problems for millions throughout the Country.  Drugs are not enough to help reduce high blood pressure as one can infer from recurrent data being tested and proven. African Americans unfortunately have the bad end of the deal, because their biological makeup reacts differently to drugs prescribed to all races. They suffer negative outcomes with beta blocker, but Diuretic is very effective in reducing water swelling of the joints and body. One would think that if a certain race has a higher prevalence of a disease they would focus on trying to reduce it, but others have different ideas and strongly believe African Americans are underrepresented and mistreated due to racism. Aside from racial beliefs, socioeconomic status plays a huge part in being able to get proper medical help. Not everyone can afford health insurance, and even if acquired certain tests and drugs are not covered or super expensive. With that said, many African Americans must look for alternative approaches to help aid in lowering chance of developing hypertension. Walk around your house, do jumping jacks like I did in class, jog in place, drink plenty of water, and reduce canned and processed meat intake. These little changes added to your diet and daily routine are very affordable, accessible, and attainable, but only if you have “within you the strength, the patience, and the passion to reach for the stars to change the world” (Harriet Tubman) and better yourself, and others around you!

References

• (2014). Racial differences in hypertension: implications for high blood pressure management. The American journal of the medical sciences, 348(2), 135-8.
• Peters, R. M., Aroian, K. J., & Flack, J. M. (2006). African American culture and hypertension prevention. Western journal of nursing research, 28(7), 831-54; discussion 855-63.
• Answers Ltd. (2018, November 22). Hypertension In African Americans And The Middle Passage. Retrieved from https://www.ukessays.com/essays/history/hypertension-in-african-americans-and-the-middle-passage-history-essay.php
• Management of Hypertension in African-Americans. (n.d.). Retrieved from https://www.uscjournal.com/articles/management-hypertension-african?page=1
• New Black American High Blood Pressure Guidelines. (2016, February 04). Retrieved from https://jay-harold.com/african-american-high-blood-pressure-guidelines-2013/
• Popular Hypertension Drugs Linked to Worse Heart Health Outcomes in Hypertensive African Americans Compared to Whites. (n.d.). Retrieved from https://nyulangone.org/press-releases/popular-hypertension-drugs-linked-to-worse-heart-health-outcomes-in-hypertensive-african-americans-compared-to-whites
• Peters, R. M., Aroian, K. J., & Flack, J. M. (2006). African American culture and hypertension prevention. Western journal of nursing research, 28(7), 831-54; discussion 855-63.
• Starting A Few New Food Habits. (n.d.). High Blood Pressure Diet. Retrieved from https://www.webmd.com/hypertension-high-blood-pressure/high-blood-pressure-diet#1
•      US Cardiology – Volume 6 Issue 2;2009:6(2):59-62

Figure 1: Hypertension rates between Whites and African Americans

Figure 1.

Prevalence of hypertension (percent of adult population). U.S. 1988-94 and 1999-2004

Adapted from: Cutler JA, Sorlie PD, Wolz M, Thom T, Fields LE, Roccella EJ. Trends in Hypertension Prevalence, Awareness, Treatment, and Control Rates in United States Adults Between 1988 –1994 and 1999 –2004. Hypertension. 2008;52:818-827; and Guo F, He D, Zhang W, Walton G. Trends in prevalence, awareness, management, and control of hypertension among United States adults 1999 to 2010. J AM Coll Cardiol 2012;60:599-606