Sunday, September 28, 2008

Hypertension Among Blacks Reaches Epidemic Proportions

Study finds high blood pressure affects one-third of city's African-Americans

By KIAWANA RICH

STATEN ISLAND, N.Y. -- Anthony Brown has had hypertension almost his entire life.

"My mother had high blood pressure and heart disease. It is hereditary," said Brown, an African-American.

For years, the St. George resident managed his high blood pressure with healthy eating and an exercise regimen. But last year, as he turned 50, the New York City Transit employee found the old routines were no longer working. So his doctor put him on medication -- as well as his two brothers and his sister, who also suffer from the condition.

"We were able to maintain it in our 40s, but now in the 50s, it's a little bit different," he said.

ON MEDICATION FOR LIFE

For Brown, now 51, the prospect of being on medication -- including facing some serious side effects, including possible impotence -- is not a happy one. "I might have to be on medication for the rest of my life," he said. "And I'm not crazy about it."



African-Americans have the highest incidence of hypertension citywide for any ethnic group -- 33 percent -- according to a report released yesterday by the city Health Department. The rate for Hispanics is 26 percent, and for whites, 21 percent.

The finding is part of a larger report that says more than 750,000 New Yorkers have uncontrolled high blood pressure, putting them at increased risk of heart disease and stroke. Black New Yorkers are more likely than whites to die of both.

Dr. Sonia Angell, the Health Department's director of cardiovascular prevention and control and lead author of the study, said African-Americans in the city and other urban areas are disproportionately affected by genetic and social factors that contribute to high blood pressure. As a group, blacks have a 50 percent higher rate of obesity than whites, are predisposed to diabetes and have a greater sensitivity to salt. Early-life poverty is also a risk factor.

OTHER DISEASES FOLLOW

The connection between blacks and high blood pressure is "longstanding -- and unfortunately, the end result of high blood pressure is kidney failure, stroke, heart attack and heart disease," said Dr. Theodore Strange, associate chairman of medicine at Staten Island University Hospital.

Dr. Strange noted that African-Americans are likely to have higher levels of two hormones, angiotensin and renin, blood pressure regulators predisposing to hypertension. Other factors, including too much salt, stress, improper diet and lack of exercise, are all contributing factors -- for any group -- to hypertension.

"On average, people eat 10 grams of salt a day when it should be no more than five grams," said Dr. Strange, adding it's not just the salt shaker at fault, but pre-packaged foods often loaded with salt.

Dr. Angell said the key to keeping blood pressure rates at healthy levels is physical activity. Another key -- a low-salt diet -- is more problematic, since 75 percent of prepared food is laden with salt.

"More exercise, less salt, more fruits and vegetables -- these are the keys to prevention," she said. "And when diet and exercise aren't enough, medication works. But you have to take it every day, even if you feel fine."

Unlike Brown, Yvette Thompson of West Brighton admits she hasn't always taken good care of herself. The 44-year-old African-American woman was diagnosed with hypertension four years ago.

TOO MUCH FAST FOOD

"It was fast food every day, all day," admitted Ms. Thompson. "I think it contributed to my getting high blood pressure."

She is now on medication, which keeps the condition under control. She's also trying to change her diet, consuming less salt and fried foods -- a far cry from the Southern-fried diet that many African-Americans have grown up eating.

The report determined that 26 percent of New Yorkers have hypertension, slightly below the national average of 30 percent. The rates for men and women were similar. For those older than 65, the rate was 71 percent.

Also, 53 percent of the nearly 1.5 million New Yorkers with high blood pressure don't have the condition under control. In addition, the study said many New Yorkers were likely to go untreated despite having access to health care. And of the 99 percent who said they've had their pressure checked, 17 percent were not aware they had hypertension.

Advance staff writer Stephanie Slepian contributed to this report.

Kiawana Rich is a news reporter for the Advance. She may be reached at rich@siadvance.com.

Source: Silive.Com

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