BookerRisingBlog links to an article that confirms what a lot of us already knew:
That high blood pressure was a killer of blacks in the USA.

….population surveys showed that this problem is more common in the Southeastern USA….people in all Southeastern states, excluding Florida, are 24 to 50 percent more likely to die of stroke than people in other parts of the country are…
They report their findings in the September issue of the Annals of Epidemiology
The researchers found higher mortality among blacks compared to whites across the South, even in Virginia and Florida, states that are not part of the Stroke Belt. It is as if blacks “sort of get penalized once for being African-American, once for being Southern and once for being black and Southern,” Howard said.

There are lots of causes of high blood pressure, but most cases are “essential” hypertension and the cause is “idiopathic”. Essentially no one knows the cause, although there are lots of theories that come and go: LINK

The good news is that it can be treated when you find it.
The bad news is that except for headache (and who hasn’t had headaches?) and dizzyness, often the first sign your blood pressure is high is a stroke or heart attack.

But why should Blacks in the Southern US have more high blood pressure than white who live in the same area, and more than blacks in other areas?

Part of it may be genetic. Just like “Metabolic syndrome”, the prediabetes problem that makes you put on weight is probably a gene that helps you put on weight so you don’t die of famine, in the same way blood pressure is related to salt and fluid retention, something that would be important in hot climates to prevent workers from dying of dehydration.

But part of the genetic is that if you are heavy you are more prone to high blood pressure, and Blacks in the US tend to be heavier than whites. This may be genetic, or it may be cultural (in many African tribes, heavy black women can be considered beautiful, whereas a white woman over size 12 is considered overweight).

Part of the problem might also be dietary: High salt intake.

Here in Asia, high blood pressure (but until recently not high cholesterol/ASCVD) is a major cause of death from heart attacks and strokes. It’s the soy sauce and Fish sauce we put on all our foods.

When I worked in rural Africa,  our village people ate bland diets with little salt. We had few cases of high blood pressure, except in the educated teachers, where it was common.

But like all arguments, the salt connection is not true for everybody, probably only for those who have a gene that makes them prone to high blood pressure. It’s probably the same with Diabetes/Metabolic syndrome. If you work hard in the fields and don’t get enough to eat, and eat a lot of starch, you will die of old age at age 55, but you won’t get diabetes or have a heart attack.

A final reason that high blood pressure causes so many strokes in Southern Blacks might also be cultural.

A lot of poor people of all colours have a passive idea of taking charge of their lives (partly because they never were allowed to take charge of their lives).

Then you have the problem of money: when the budget is tight and there aren’t a lot of doctors around, and when those docs are often of a different race or even from another country, people just don’t take time out to go to the doctor.

Some areas get around this by having local churches and groups sponsor “blood pressure” screening to detect people whose blood pressure is high but are unaware that they have a problem.

One of the shortcomings of the private practice style is just such lack of outreach time. HMO’s will outreach, but only to their own people. Often it is volunteer groups such as the American Heart Association that plan such outreaches into the community.

Every May is National High Blood pressure screening month, and their web page has a “How to” page to tell you how to set up such a program at your church/business/ mall/club.

Churches are especially important in outreach to the immigrants and Black community. Historically they are the one institution historically that allowed black leadership and is usually trusted by the local community, and for immigrants, churches often have translators and cross cultural personnel to help in screening programs.

When I worked in rural towns, local docs and nurses would “screen” once a month after church services, pharmacies would hold “Blood pressure” day screening, and the local mall or department stores often would hold “Health Days” for blood pressure and blood sugar screening.

Even here in the Philippines, the Catholic church sponsors a free clinic once a month, and health screening days twice a year. Here blood pressure is a killer, and one of my “Jobs” is to check the blood pressure of our employees and their families. Nearly every family knows someone with a stroke or death from high blood pressure, so people are eager to know if their numbers are okay.


Nancy Reyes is a retired physician living in the rural Philippines. Her webpage is Finest Kind Clinic and Fishmarket, and she writes medical essays at Hey Doc Xanga Blog.

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