Only 9.9% of all adults did not exceed their applicable limit of intake (CDC, January 2011)
Most single anti-hypertensive medications or effective in controlling blood pressure in only 50-60% of patients, and this effectiveness rating greatly declines among individuals with stage 3 hypertension and renal insufficiency, which is common among both African-Americans and those with diabetes (Flack & Hamaty, 1999). Furthermore, hypertension is experienced more frequently and more severely among African-Americans than in other racial populations, which inevitably has led to greater morbidity and mortality among this population (Brewster, van Montfrans, Kleijnen, 2004)
Race and Anti-Hypertensive Medications Hypertension is a prevalent cardiovascular condition among American adults, with one third of adults in the United States being afflicted (Ferdinand & Saunders, 2006)
The prevalence of these comorbidities and hypertension in general among the African-American population has indicated the potential need for the development of a single dose treatment that contains more than one therapeutic agent (Ferdinand & Saunders, 2006). There are distinct similarities between African-Americans and individuals with diabetes as hypertensive populations that are difficult to treat (Flack & Hamaty, 1999)
The results of the study indicated that Fosinopril was effective in treating hypertension in all racial groups, but Black children in the study required a higher dosage of the anti-hypertensive medication in order to experience the beneficial results. Furthermore, the differences in ACE inhibitor efficacy observed among adults of different races exist also in children of various races (Menon et al
Papademetriou, Narayan, and Kokkinos (2004) studied the effectiveness of ACE inhibitors in relation to angiotensin receptor blockers and the extent of cross-resistance to these anti-hypertensive agents among African-Americans. Results indicated that approximately equal proportions of the population under study responded favorably to each type of medication, while only a small proportion (14%) responded to both types of medication and a rather large proportion (48%) were non-responsive to either medication (Papademetriou et al
, 2006). Overall, research has repeatedly demonstrated that the most optimal therapeutic treatment for hypertension among African-Americans is the initiation of a low-sodium diet in conjunction with a thiazidetype diuretic (Rao, 2007)
This view is put forth at the same time that the much higher prevalence of hypertension in the African-American community is acknowledged by the authors, however, calling their conclusions in this regard highly into question (Harvard 2003). One interesting research article suggested that due to the higher prevalence of hypertension and related chronic diseases in the African-American community, it might actually be advantageous and lead to better health outcomes to set lower and more achievable blood pressure goals in this community (Douglas et al
In addition, this suggests that there are certain predispositions that both affect hypertension and interrupt the mechanisms of drugs proven efficacious in other communities, which could provide greater insight into why hypertension remains so prevalent amongst African-Americans (Lackland 2004). This and similar advances in research have not been adequately pursued, however, in fact evidence from the beginning of the decade suggests that the fight against a higher prevalence of hypertension in the African-American community might already be on a losing streak (Glover et al
"Hypertension prevention" and "African-American" made up a final search that led to the discovery of several additional highly relevant yet broad-viewed articles that provided an excellent foundation for the specific findings of this literature review. Literature Review Culturally specific attention to hypertension amongst African-Americans has already been the focus of several studies, and prevention programs focused on the African-American community have also been a part of the medical community's response to this issue (Heartline 1998)
2005). An even more demonstrable disparity exists in the recommended best practices for treating individuals with hypertension and the actual treatment that African-Americans receive for their diagnosed hypertension (Henderson et al
2009). Certain studies have also demonstrated a reduced efficacy of certain blood-pressure regulating pharmaceuticals in the African-American community, with certain individuals responsive to one type of medication but not others (Lackland 2004)
1999). Again, the most direct and culturally specific method for addressing and preventing hypertension in the African-American community is found in the push for increased educational efforts and awareness campaigns among this community rather than in direct medical interventions and prevention strategies (Moulton 2009)
This shows the beginnings of some culturally-specific adjustments, but still not the development of culturally-specific prevention strategies. Other studies have identified key culturally-specific risk factors that can be addressed as part of culturally-specific prevention strategies, though as of yet such strategies have not been successfully developed (Pekmezi et al
One of the most direct studies regarding the cultural issues involved in preventing hypertension in the African-American community focused far more on cultural influences than on medical interventions and means of overcoming cultural barriers. In many ways, this study suggests, the perception of a "closed" and "different" African-American culture held by many African-Americans is counterproductive to prevention strategies, as it reinforces health habits and attitudes from generation to generation and penalizes anyone who is perceived as acting "different" from the African-American cultural norm, in aspects such as eating healthier or exercising for the sake of heart health (Peters et al
More direct medical interventions aimed at addressing and preventing hypertension in the African-American community have also been established, studied, and published in the literature, of course, but often these consist of the same basic recommendations made for preventing and/or combating hypertension in all cultures. The low-sodium Dietary Approaches to Stop Hypertension (DASH) diet, for example, has been found to be quite effective at reducing hypertension levels and achieving blood pressure goals in patients generally as well as in African-Americans specifically (Rao et al
2007). This does not mean that the DASH diet is an ineffective means of preventing hypertension in African-Americans, however, and in fact some preliminary research suggests that African-Americans actually derive a better-than-average health result from this intervention method due to complexities such as lactose maldigestion that also affect African-Americans in great numbers and to a greater degree (Reusser & McCarron 2006)
Of course, blood pressure increases with age, due to the decrease in distensibility of the veins and arteries. As a person grows older, "an increase in systolic pressure often precedes an increase in diastolic pressure" (Baggish, a
The pressure in the aorta and the large arteries of a healthy male adult is approximately 120 mm Hg during systole and 70 mm Hg in diastole with a pulse pressure of about 50 mm Hg. Some of the known causes of hypertension include adrenal disorders, such as aldosteronism, "a condition characterized by hypersecretion of aldosterone of the adrenal cortex" (Chummun, H
For example, a family member with hypertension might be faced with a number of family-related problems which only increase the symptoms of the disorder, such as constant worry about a son's or daughter's conduct at school or their activities which tend to increase stress levels at home. Also, a family member with hypertension might face certain situations related to having to make important family decisions which could create "mood swings, anger and a good amount of anxiety" (Forman, J