Written by:Eli Ben-Yehuda, July 10, 2018

Arterial hypertension is prevalent in the black population in the United States. It is directly related to cardiovascular and kidney damage. Its pathogenesis is complex and includes the high incidence of obesity, salt sensitivity and the activation of the renin-angiotensin-aldosterone system.

This complexity requires a therapeutic combination that includes changes in dietary habits and appropriate antihypertensive regimes. The International Society of Hypertension in Blacks recommends initiating dietary intervention for values of systolic/diastolic arterial blood pressure above 115/75 mmHg and maintaining arterial blood pressure below 135/85 mmHg using appropriate antihypertensive medication. The most adequate antihypertensive drug for this population has yet to be determined.

African Americans in the U.S. have a higher prevalence of high blood pressure (HBP) than other racial and ethnic groups. It is also often more severe in this groups, and some medications are less effective in treating HBP in them.

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High blood pressure usually has no symptoms. That’s why it’s called the “silent killer.” The only way to know if your blood pressure is high is to have your healthcare provider check it regularly.

The good news is, African-Americans can improve their odds of preventing and beating these diseases by understanding the risks and taking simple steps to address them.

“We’ve made tremendous progress in the area of hypertension in African-Americans in recent decades, but it’s still a huge problem,” said the report’s lead author Paul Whelton, M.D., chair of global public health at Tulane University. “African-Americans still have considerably lower hypertension control rates and more complications for any given level of high blood pressure compared to whites. It’s the biggest problem in high blood pressure in this country, and we need to find ways to close the gap for disparities.”

The report also called for more research in the area of genetic and pharmacogenomics and how they relate to heart and kidney disease caused by high blood pressure.

But Whelton cautioned that scientists should be judicious when it comes to genetic-related “precision medicine.” He points out that the report concludes “environmental, behavioral and psychosocial factors probably play a more important role than genetics in the higher prevalence of hypertension in African-Americans.”

Whelton said more studies are needed to see what the relationship is between diet and hypertension in African-Americans — especially healthy diets with reduced sodium and increased potassium.

“There may be an insufficient intake of potassium products like fruits and vegetables, especially in areas where you have so-called ‘food deserts’ where you don’t find fresh vegetables,” Whelton said. “Also, in some parts of the country, it may have to do with traditional preparation methods where vegetables are boiled and strained and the potassium is extracted in the process.”

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According to new research coming out of UT Southwestern Medical Center Cardiologists stated, “African-Americans have more rigidity of the aorta, the major artery supplying oxygen-rich blood to the body, than Caucasians and Hispanics.” Why is this finding so important? The reason is that African Americans are the largest group at risk for high blood pressure and organ damage related to high blood pressure.

According to figures from the Centers for Disease Control and Prevention, 43 percent of African-American men and 45.7 percent of African-American women have hypertension, or high blood pressure, compared with 33.9 percent of Caucasian men and 31.3 percent of Caucasian women.

Research suggests African-Americans may also carry a gene that makes them more salt sensitive, increasing the risk of high blood pressure. Your healthcare provider can help you find the right medication, and lifestyle changes can also have a big impact.

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