Title: Why Do Black Americans Have Higher Prevalence of Hypertension? | Hypertension
Headings: Why Do Black Americans Have Higher Prevalence of Hypertension?
Why Do Black Americans Have Higher Prevalence of Hypertension?
An Enigma Still Unsolved
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Content: These genetic defects may account for the higher propensity of blacks to develop end-stage renal disease, which may then induce hypertension, rather than hypertension being responsible for the renal damage. Nonetheless, the possible role of these or other genetic defects in the large majority of blacks without focal segmental glomerulosclerosis or end-stage renal disease remains unknown, particularly with regard to differences in the renal handling of sodium between normotensive black subjects living in Africa and the United States. Differences in exposure to the environment and habits between blacks and whites have also been proposed to explain their differential prevalence of hypertension. Many potential reasons have been reported, such as socioeconomic status, dietary habits, social network, stress, and health behaviors. Among the consequences of differential dietary habits, excess adiposity emerges as a natural candidate to explain the higher prevalence of hypertension in blacks, who have a 51% greater prevalence of obesity than whites. 9 Nonetheless, excess of adiposity does not fully account for the higher prevalence of hypertension in blacks. Based on data of National Health and Nutrition Examination Survey (NHANES) III, Okosun et al 10 demonstrated that the population-attributable fraction of hypertension attributed to abdominal obesity was 24.9% in black men and 15.9% in black women. The risk of black ethnicity for hypertension persisted after adjustment for abdominal obesity and other confounders: the odds ratios in black men were 1.80 (95% CI: 1.54 to 2.11) and in black women 2.70 (95% CI: