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Hypertension

The Facts

Blood pressure is the force exerted by blood against the walls of arteries as the heart pumps blood. High Blood Pressure (or hypertension) is a chronic increase of blood pressure to levels above normal. Blood pressure is reported as two values: the systolic (when the heart contracts) and diastolic (when the heart relaxes after a contraction). Normal blood pressure in adults is 120/80 (read as one twenty over eighty) and is measured in millimeters of mercury. Hypertension is defined as a blood pressure of 140/90 or more on repeated testing over time. (New guidelines suggest an even lower standard). The condition is very common and affects as many as 65 million Americans. High blood pressure increases the risk of heart attacks, strokes, kidney failure, damage to the eyes, congestive heart failure and atherosclerosis. 

Hypertension is more common among African Americans. In the US, approximately one in three African Americans has hypertension compared to one in four Whites. African Americans develop high blood pressure earlier in life and at every age have higher blood pressure than Whites. Approximately 71% of blacks 60 years or older have hypertension. In 1995, the death rate from high blood pressure was 29.6 for Black males (355% higher than for White males) and 21.7 for Black females (352% higher than for White females.)

The excess of hypertension among blacks has been recognized for a long time but the cause remains unclear. Environmental rather than genetic causes may be involved. . There appears to be a gradient in risk with standardized prevalences of 14% in West Africa and 26% in the Caribbean, compared to 33% in the US. This pattern parallels the gradient in known risk factors, with obesity alone accounting for a third of the excess in the US compared to Africa.


Symptoms 

Hypertension can occasionally cause headaches, vision problems, dizziness, or shortness of breath - but most people with hypertension have no symptoms. This is why hypertension is referred to as the "silent killer."

Causes

In most cases, the cause of hypertension is unknown and this is called primary (or essential) hypertension.  When there is an underlying problem such as kidney disease or hormonal derangements that can cause hypertension, it is called secondary hypertension. Other factors associated with hypertension are listed below:

  • Hereditary factors
    • age (blood pressure usually increases with age)
    • race (Blacks)
    • men (more than women)
  • Lifestyle factors
    • high salt in diet
    • excessive alcohol consumption
    • lack of exercise
    • obesity
    • stress

Treatment 

Although 54 percent of all hypertensives are being treated with anti-hypertensive medications, only 27 percent have their blood pressure under control. That means that more than 36 million Americans do not have their blood pressure under control. Also, many persons fail to understand that treatment is generally lifelong. So, they prematurely stop taking medication after the pressure is controlled. However, after a period of time the pressure generally creeps up again and unless followed by a physician this may not be detected.

The management of hypertension includes lifestyle changes and the use of medications. Proper treatment can decrease the risk of stroke and heart disease. While garlic and other remedies may contribute to lowering blood pressure in mild cases, they should never be used without first consulting a physician. The recommendations below are endorsed by leading health organizations including: the American Heart Association, the Association of Black Cardiologists, the Consortium for Southeastern Hypertension Control, and the National Medical Association

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  • Combination therapy – many African Americans will need to start on at least two medications to successfully lower their blood pressure.
  • A lower blood pressure target of 130/80mm Hg is recommended for African Americans with high blood pressure and other conditions like heart disease, kidney disorders, or diabetes.
  • African Americans with diabetes should receive medications that have been shown to slow the progression of kidney disease, such as ACE inhibitors or angiotensin II receptor blockers (ARB’s), as part of their combination of medications.

Prevention  

To prevent hypertension and heart disease, here are some healthy lifestyle tips:

  • Cut down on salt intake.
  • Get at least 30 minutes of physical activity most days of the week.
  • Achieve and maintain an appropriate weight.
  • Limit alcohol intake (no more than 2 drinks per day).
  • Quit smoking.
  • Take medications as prescribed.

The U.S. National Institutes of Health Working Group on primary prevention of hypertension, after reviewing over 300 studies, were also in favor of potassium supplementation, but were less convinced of the benefits of calcium, magnesium, fiber, or stress management.

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Sources: http://ishib.org/supportfiles/fact_hypertension.pdf; American Heart Association; British Hypertension Society; International Society on Hypertension in Blacks;http://www.ishib.org/HI_abohyp.asp;  Disclaimer: All content within this Web site is intended for general information only and is not intended as a substitute of any kind for professional medical advice, diagnosis or treatment. We are not responsible or liable for any diagnosis made by a user based on the content of this website. We are not liable for the contents of any external internet sites listed, nor do we endorse any commercial product or service mentioned or advised on any of the sites. Always consult your own physician if you are concerned about your health.