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Hypertension: A Silent Assassin


The holidays are the time of year when what I call the two “Fs” are exceedingly common: Feasting and Fellowship. “Soul Food” is commonplace on our dinner tables, and a health-conscious diet tends to fall by the wayside. Hypertension, AKA High Blood Pressure, is a condition that negatively affects more than 28% of Americans and approximately 46% of African -Americans as a group.

Researchers do not have a definitive answer to this question, but some believe the following things have something to do with it:

  • Genetic factors. High rates of high blood pressure in Black people may be due to the genetic makeup of people of African descent. Researchers have uncovered some facts: In the U.S., Black people respond differently to high blood pressure drugs than do other groups of people. African Americans also seem to be more sensitive to salt, which increases the risk of having high blood pressure.
  • Environmental factors. Some scientists believe that high blood pressure in Black people is due to things unique to the experience of African Americans. Black people worldwide have high blood pressure rates similar to that of white people. But in the U.S., the difference is dramatic: 41% of African Americans have high blood pressure compared to 27% of white Americans. In addition, Black people in the U.S. are more likely to be overweight than Black people in other countries. Some experts think that social and economic factors – including discrimination and economic inequality – are responsible for this difference.

Several Factors weigh in on some major contributions to this condition:

  • Increased age
  • Excessive weight
  • A family history of high blood pressure
  • Having diabetes
  • Inactivity
  • Lots of salt and fat in your diet
  • Not getting enough potassium
  • Smoking

Your doctor can easily measure blood pressure. A blood pressure reading includes two numbers, one written on top of the other.

The top number is called your systolic blood pressure. This number represents the force of blood through your blood vessels during your heartbeat.

  • 119 or below is the normal systolic blood pressure.
  • 120-129 is elevated.
  • 130-139 and greater is Stage 1 high blood pressure.
  • 140 and higher is Stage 2 high blood pressure.
  • 180 or above is a hypertensive crisis. Call 911 immediately.

The bottom number is called your diastolic blood pressure. This number represents the force of blood through your blood vessels in between heartbeats while your heart is resting.

  • 79 or below is normal diastolic blood pressure.
  • 79 or below, combined with 120-129 systolic, is elevated.
  • 80-89 is Stage 1 high blood pressure
  • 90 and greater is Stage 2 high blood pressure.

If you have high blood pressure, consult your doctor to find which combination of treatments works best, given your individual health and lifestyle. Your treatment plan is likely to include the following elements:

  • Follow the DASH eating plan. The Dietary Approaches to Stop Hypertension (DASH) diet plan includes eating less fat and saturated fat, as well as eating more fresh fruits and vegetables and whole-grain food. Limiting alcohol consumption can also help lower your blood pressure. A dietitian can help you find ways to meet these goals without giving up your favorite foods.
  • Limit salt intake. Because Black people seem more sensitive to salt, it makes sense to watch how much salt you eat. Table salt and sodium used in processed foods are the two sources of sodium in your diet. Consult a dietitian to learn how to select and prepare tasty, low-salt meals.
  • Watch your weight. Being overweight increases your risk of high blood pressure. Following the DASH eating plan and getting regular exercise can help you lose weight. Ask your doctor to help you determine a goal. Your doctor can also refer you to other healthcare professionals for help in setting up a weight loss plan.
  • Quit smoking. Tobacco smoke can make blood pressure rise. It can also directly damage your heart and blood vessels. Talk with your doctor about ways to quit.
  • Medication. Your doctor may prescribe medication to control your high blood pressure. It's common to take more than one drug to treat the problem. Your doctor may ask you to switch drugs or change the dosage until you find a combination that works best to control high blood pressure with the least side effects for you. Drugs used to treat high blood pressure include:
    Diuretics, reduce the amount of fluid in your blood by helping your body rid itself of extra salt. This type of blood pressure medication should be used in most cases to treat high blood pressure.
    Calcium channel blockers, ACE inhibitors, and alpha-blockers help keep your blood vessels from tightening up. Your doctor may want to start with calcium channel blockers by themselves or in combination with diuretics.
    Beta-blockers prevent your body from using the hormone adrenaline by blocking the cell receptors for it. Adrenaline is a stress hormone. It makes your heart beat harder and faster. It also makes your blood vessels tighten. All of this makes blood pressure higher.
  • It is also important to note that blood pressure alternates throughout the day, depending on one’s activities. Check your blood pressure as often as recommended by your doctor.
  • Follow your treatment plan consistently. Let your doctor know right away if you have problems with part of the plan. Your doctor may refer you to other healthcare professionals who can help.
  • See your doctor as often as requested. Bring your blood pressure records to show your doctor how well the plan is working.
  • Ask your doctor or pharmacist for information about medication side effects. Know when to call your doctor if there is a problem.

Your knowledge about the risk of high blood pressure is the first step in controlling this condition so you can remain as healthy as possible for years to come.


Hildreth CJ, Saunders E.Md Med J. 1991 Mar;40(3):213-7.PMID: 2008167


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Hypertension, High Blood Pressure, Holiday, African American, Risk Factors


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