Hypertension in African American Adults

Hypertension, which is also referred to as the high blood pressure, tends to be a condition in which the blood exacts pressure against the artery walls, eventually resulting to various health problems such as heart diseases, stroke, and heart failure. The blood pressure is mainly determined by the amount of blood that the heart pumps to the body and the level of resistance to blood flow that is experienced in the arteries. Hypertension is mainly caused by various risk factors that include age, genetics, family history, obesity, and tobacco and alcohol use. According to various reports, approximately half of the United States population, particularly the African Americans, are affected by this health condition (Lewis, Barnes, Bienias, Lackland, Evans, & Mendes de Leon, 2009). This paper intends to discuss and asses cases of hypertension among the African American adults.

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Literature Review on Hypertension in African American Adults

In the united states, the number of hypertension cases recorded by the African Americans tends to be high compared to the number of hypertension cases reported by the rest of the populations such as the whites and the native Americans. According to various reports, more than 40% of African American women and men are perceived to have high blood pressure across the United States. Most of the African Americans tend to develop hypertension at an early age compared to other groups (Ibrahim & Damasceno, 2012). African Americans are also at a higher risk of developing various complications related to hypertension, such as stroke compared to other populations across the country (Whitfield, Yao, Boomer, Vogler, Hayward, & Vandenbergh, 2009). The prevalence of hypertension among African Americans tends to be high due to various reasons that include, first, genetic factors. The genetical makeup of African Americans tends to increase their vulnerability to high blood pressure. It has also been identified that African Americans usually respond differently to hypertension drugs as compared to other groups in the United States. The blacks are also considered to be sensitive to salt, which tends to increase the risk of developing high blood pressure. For the blacks with this type of gene, a half teaspoon of salt could increase the blood pressure by 55mm hg (Warren-Findlow, Seymour, & Huber, 2012).

Secondly, environmental factors, scientists tend to believe that hypertension in African Americans is influenced by various environmental conditions that surround them. For instance. The nutritional habit of people living in a certain area. It is considered that the blacks in the United States are at a higher risk of being overweight and developing obesity as compared to the blacks living in other countries. According to United States statistics, approximately 20% of the hypertension-related diseases are found among the African Americans (Ibrahim & Damasceno, 2012). In most cases, scholars tend to believe that the link between economic and social factors such as economic equality and discrimination are also responsible for these differences.

Pathophysiology of Hypertension

Hypertension is considered to be the chronic elevation or increase of blood pressure, which in the long term causes various endo organ damages, and also result to enhanced mortality and morbidity. Blood pressure is considered to be the product of systemic vascular resistance and cardiac output. For instance, a patient with arterial hypertension may experience an increase in the cardiac output, which is then responded to with an increase in systemic vascular resistance. In most cases, people in the younger age groups usually have a higher cardiac output, while the individuals in the older age groups tend to have an elevated systemic vascular resistance (Lewis et al., 2009). The vascular tone tends to be elevated or enhanced because of the increased or elevated adrenoceptor stimulation. The final pathway in hypertension is the increase in cytosolic calcium located in the vascular smooth muscles resulting to enhanced vasoconstriction. Various growth factors such as endothelins and angiotensin tend to cause an increase in the systemic vascular muscle resistance and also cause an increase in the vascular stiffness, which tends to be the load that is imposed on the left ventricular (Ibrahim & Damasceno, 2012). This reaction induces or causes the left ventricular hypertrophy and also causes the left ventricular diastolic dysfunction. In the young individuals, particularly the youth, the pulse that is created by the left ventricle is considered to be relatively low, while the waves that are reflected by the peripheral vasculature tend to occur particularly at the end of the systole thus increasing pressure at that early stage of the diastole. With age, the stiffness of the elastic arteries and the aorta tends to enhance the pulse pressure. The final results tend to be an increase in the left ventricular afterload, which then results to the left ventricular hypertrophy.

On the other hand, the autonomic nervous system plays a key role in the control of blood pressure. In most cases, the hypertensive patients tend to indicate increased peripheral sensitivity to norepinephrine and enhanced responsiveness to the stressful stimuli. Another key feature of arterial hypertension is the reduced baroreceptor sensitivity and the resetting of the baroreflexes. Renin-angiotensin system is mainly involved in some form of hypertension and such as renovascular hypertension, and it is also considered to be suppressed when in the presence of the primary hyper aldosteronism. In experimental hypertension and essential human hypertension, the relationship between sodium extraction and blood pressure is considered to be abnormal(Whitfield et al., 2009). Evidence usually suggests that resetting of the pressure natriuresis plays a critical role in triggering hypertension. While in the patients suffering from essential hypertension, the resetting of the pressure natriuresis is mainly characterized either by the parallel change to high blood pressure and the salt insensitive hypertension or by the decreased slope of the pressure natriuresis and salt-sensitive hypertension.

How Hypertension Affects the African American Population

The increased cases of hypertension among African Americans tend to affect them in various ways that include; first, they usually lead to the damage of arteries. Healthy arteries are considered to be strong, elastic, and flexible, While their inner linings are smooth to facilitates the free flow of blood through the vital organs in the human body. Hypertension tends to gradually increase the pressure of the blood flowing in the arteries, thus damaging the cells of the inner linings of the arteries. The fats collected in the body usually enter the arteries through the damaged areas, eventually causing the artery walls to be less elastic, thus limiting the amount of blood flowing to other body parts such as the heart, which eventually results to death (Whitfield et al., 2009). This tends to be a huge blow to African Americans since such deaths reduce the population of African Americans across the country. Secondly, damages the heart, the heart usually pumps blood to the whole body, however, uncontrolled blood pressure tends to damage or affect the heart in various ways such as triggering the coronary heart diseases, which tend to affect or impact the arteries that usually supply blood to the heart. Also, causing heart failure, which mainly occurs due to the constant straining of the heart muscles, thus making the muscles weak. Thirdly, hypertension causes kidney damage, for the kidney to effectively filter out the excess wastes and fluids from the blood; it has to depend on the effort of the healthy blood vessels. High blood pressure tends to injure the blood vessels leading to the kidney, thus causing several types of kidney diseases and eventually resulting to kidney failure.

Conclusion

Hypertension tends to be a condition in which the blood exacts pressure against the artery wall resulting to various health complications such as heart failure. In the United States, cases of hypertension are higher among African Americans. The increased cases of high blood pressure among the blacks are triggered by various factors that include, first, the genetical factors. The genes of African Americans are considered to be very vulnerable to hypertension. Also, they are considered to be very sensitive to the risk factors of high blood pressure, such as high salt intake. Secondly, environmental factors. It is considered that the blacks living in the United States tend to record high incidences of hypertension as compared to the blocks living in other countries. Hypertension tends to affect the African Americans in various ways that include first results to increased heart kidney diseases among African Americans. Secondly, it causes increased cases of heart failure among African Americans.

References

Lewis, T. T., Barnes, L. L., Bienias, J. L., Lackland, D. T., Evans, D. A., & Mendes de Leon, C. F. (2009). Perceived discrimination and blood pressure in older African American and white adults. Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences, 64(9), 1002-1008. Retrieved from https://doi.org/10.1093/gerona/glp062

Ibrahim, M. M., & Damasceno, A. (2012). Hypertension in developing countries. The Lancet, 380(9841), 611-619. Retrieved from https://www.medbox.org/preview/533bc0ef-345c-46a6-bee3-65fe1fcc7b89/doc.pdf

Warren-Findlow, J., Seymour, R. B., & Huber, L. R. B. (2012). The association between self-efficacy and hypertension self-care activities among African American adults. Journal of community health, 37(1), 15-24. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3179559/

Whitfield, K. E., Yao, X., Boomer, K. B., Vogler, G. P., Hayward, M. D., & Vandenbergh, D. J. (2009). Analysis of candidate genes and hypertension in African American adults. Ethnicity & disease, 19(1), 18-22. Retrieved from https://europepmc.org/abstract/med/19341158