hypertension in african american

The fact that African Americans have higher risk of having hypertension remains an enigma. Researchers from across Europe and the United States have conducted studies on the topic and the possible links between black Americans and their higher prevalent rate to hypertension. The purpose of this paper is to provide a scholarly analysis of the prevalence of hypertension among the blacks. It will also look at the possible explanations as put forward by a number of scholars.

Hypertension or high blood pressure according to Faye and Kelvin (2005,268) can be said to be a condition of “having elevated blood pressure- systolic pressure of at least 140mm or diastolic pressure of at leat 90mm Hg.” Incidences of high blood pressure increases as one advance in age. Individuals who are 50 years old and above are considered to have an increased risk of high blood pressure.

Without routine medical checks it is difficult to detect hypertension. Due to its symptoms, some people believe they are having mental tension as it might come with incidences of fatigue and constant headaches which are common in high blood pressure patients. Though it has been found to affect people who are aged from 50 years and above, in the African American population, people aged much lower than that have been diagnosed with hypertension. Young African Americans have been found to be severely suffering from high blood pressure and have been recording high rate of mortality from diseases such as kidney failure and other cardiovascular complications. Indeed, out of 65 million people with hypertension in the United States, African Americans in proportion to other races comprise the highest number. Faye Z. and Kelvin W. (2005, 268) note that over the years, for “every 100,000 people in the population, hypertension is the cause for 836.5 deaths of whites and 1101.2 deaths of African Americans.” This indicates that African Americans are 1.3 times likely to develop hypertension compared to their white counterparts. This situation exacerbates further as it is even likely to affect young African Americans in their thirties and early forties.

The etiology of high blood pressure remains a complicated issue. Majority of researchers claim that the differences across the racial groups maybe explained along genetic and physiological lines (Hideo I.,Yoshiji Y, 2003).

 To understand the differences across the racial groups, it is important to take a look at the possible causes of hypertension. There are two types of hypertension. There is the essential or the primary hypertension and the secondary hypertension. Essential hypertension is the most common and takes over 90% of all the cases of hypertension. There are a multiplicity of factors that can be said to be behind the essential hypertension, the exact factors are yet to be pinpointed with precision despite the fact that it affects over fifty million of Americans. Obesity, increased intake of salt, genetics and the factor of age are recognized as playing the greatest role (Messerli FH, Williams B,Ritz E ,2007).

To some researchers, genes have a prominent role behind essential hypertension. Above 30% of hypertension cases are as a result of genetic factors. The specific genes that are more prone to hypertension are yet to be identified and intense research is being conducted to validate the claims. This is considered to be the key culprit behind the high prevalence rate amongst African Americans compared to that of Asians and white Americans.  With the exact causes of  hypertension being unclear in regard to the African Americans, it remains unclear “how much of that risk is due to differences in diet , exercise, social economic status, genetics or a combination of these factors.” (Amy Adams, 2005) in addition, Amy A. observes that the discovery of genes that causes hypertension in African Americans will not be enough as there are various issues  that will need to be addressed. She enquires whether such a gene alone can “cause hypertension even in a person who exercises regularly?”

Indeed the issue of hypertension amongst the African American population is riddled with medical and political controversies. Various scholars have hypothesized on the causes of such high rates of prevalence amongst the African Americans in relation to other ethnic groups. It is true that African Americans face a number of unique problems compared to the whites. It is such problems that have been promulgated by a number of scholars as being the factors behind high rates of mortality from high blood pressure.

Faye Z. and Kelvin W. trace such link to poverty. To them, “the prevalence of hypertension is higher among African Americans who are poor because it is less likely to be controlled.”  The meager medical attention and the inability to access medical care is a factor contributing to high cases of hypertension among this population. Such a statement has been backed by a variety of scholars who see the unique history of black Americans at play. According to some scholars, slavery is behind the cases of hypertension amongst African Americans. As afore mentioned, salt intake is a contributing factor for high blood pressure. Scholars pinpoint that as African slaves were supplied from regions that were not deficient in salt, they developed an inherent affinity to hypertension. The second cause of hypertension related to slavery is the problems that were faced aboard the ships and the maladies that could have contributed to the development of high blood pressure.

The slavery hypothesis was developed in the early 1980s and tends to emphasize the role of slavery as a possible explanation of exaggerated incidences of high blood pressure amongst the blacks. This was a hypothesis that drew intense mixed reaction from both the media and medical researchers. This hypothesis has been refuted by many but it has its own sizeable support from researchers who claimed that “it is this selective survival among the descendants of surviving slaves of genes responsible for an increased ability to hold on to salt that is now responsible for the exceptionally high prevalence of hypertension in African Americans.” (Jay Kaufman , 2005)

This hypothesis has been debated widely and is refuted by many. Likewise, the gene assumption is also put into disrepute by the fact that majority of West Africans where most slaves originated from have a low blood pressure. This hence indicates that no one factor can be said to be behind the high rate of hypertension cases among the blacks. According to Grace Budrys (2003), “the whole issue is more complicated than” the proponents of the slavery hypothesis would want us to believe.

There are arguments too that tend to indicate that “blood pressure increases when blacks move from original communities to large urban communities.” (Faye Z. and Kelvin W.) This however is not backed by statistical evidence.

As afore mentioned, the high prevalence rate amongst African Americans is as a result of a multiplicity of factors, their skin color included. It is hence important in such an analysis to look at the socio-economic problems facing this particular group and how it may contribute towards the development of high blood pressure. John Henryism is used to explain such link. John Henryism, as hypothesized in the 1980s, “refers to a strong personality predisposition to cope actively with psychosocial environment stressors.” (James et al, 1987). An analysis of poverty index and per capita income across the racial groups indicates that African Americans score the lowest as afar as income is concerned. Blacks are in the lower scale in terms of literacy, employment and access to health facilities. They have continued to be in such a situation since their forceful immigration to America in the days of slavery. According to John Henryism, the socio economic position of African Americans means that they are more hypertensive compared to other racial groups.

            The discovery that African Americans are more prone to hypertension should be enough to warrant increased medical attention from the government. Whether the problem is gene related or linked to slavery should not be a factor in urging for favorable health policies to African Americans. Lack of proper medical attention and late diagnosis may lead to increased mortality and hence there should be concerted effort from the health providers and the individuals themselves to address the situations before it spirals out of control. Hypertension can also be addressed through behavioral change. Statistics have it that Hispanics and African Americans top the list in smoking and in drug abuse. Such habits can lead to increased cases of hypertension.


Jay Kaufman January 26, 2005 . The Anatomy of a Medical Myth. Stanford Report. ssrc.org. Retrieved on October 2, 2008 from http://raceandgenomics.ssrc.org/Kaufman/

James, S. A., D. S. Strogatz, S. B. Wing, and D. L. Ramsey, 2004. Socioeconomic status, John Henryism, and hypertension in blacks and whites. Am J Epidemiol 1987; 126:664–73.

Washington University School of Medicine, 2005. Hypertension In African Americans Linked To Two Genomic Regions. Retrieved on October 2, 2008 from


Hideo Izawa; Yoshiji Yamada, 2003. Prediction of Genetic Risk for Hypertension. Hypertension 41(5): 1035–1040.

Grace Budrys,2003.Unequal Health: How Inequality Contributes to Health Or Illness. Rowman & Littlefield.

Faye Z. Belgrave, Kevin W. Allison, 2005. African American Psychology: From Africa to America.SAGE

Amy Adams, 2005. Genetics key to African-Americans’ hypertension. Stanford news service.Stanford University

Messerli FH, Williams B,Ritz E, 2007. Essential hypertension. Lancet 370(9587): 591–603


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