Review of Management of Hypertension in African-Americans
Authors’ Credentials: Carola Maraboto and Keith C. Ferdinand.
Previous publications: The authors have previously published several articles, the most recent one being “Is Electrocardiography-Left Ventricular Hypertension an Obsolete Marker for Determining Heart Failure Risk with Hypertension?” in April 2019.
Carola Maraboto has been cited in other works forty-one times, while Keith C. Ferdinand has had 9,769 citations.
Carola Maraboto is a doctor at the Tulane University of Heart and Vascular Institute in New Orleans, Louisiana. Keith C. Ferdinand is an M.D, FACC, FAHA, FASH, and FNLA Professor of medicine at the Tulane University School of Medicine and the Tulane Heart and Vascular Institute in New Orleans, Louisiana. Both authors have experience with numerous previous works on cardiovascular disease. The article was reviewed and published by Elsevier.
“Update on hypertension in African-Americans” by Carola and Ferdinand has identified high cases hypertension among the black Americans according to the 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults. The authors also state that black Americans develop hypertension at an early age in comparison to the whites; and that they exhibit a higher mortality rate from hypertension complications such as heart failure, stroke, and end-stage renal disease (ESRD). Research by Jackson Heart Study and the Reasons for Geographic and Racial Differences in Stroke estimated that 32.5% of the black adult Americans are at risk of cardiovascular disease, which could increase their chances of hypertension.
According to Carola and Ferdinand, some of the possible causes of hypertension in blacks include obesity, genetic polymorphism, unhealthy dietary habits, higher salt sensitivity, low levels of plasma renin, abnormal vascular function, perceived discrimination, low education level, and socioeconomic status. A study by Genetics of Hypertension Associated Treatments explored the links between hypertension genes and clinical outcomes in a population with multiple races showed that; genetic polymorphisms in the renal epithelial sodium channel might account for approximately 6% of hypertension in black individuals. A study also revealed that the diet of the blacks constituted a high intake of fried food, egg, organ meat, sugar-sweetened beverages. Such a diet account for 52% of the excess risk of hypertension among men, and 29% in black women. (Carola & Ferdinand, 2019) Chicago Health and Aging Project carried out a study and reported that older black individuals with perceived discrimination, such as racism, were a factor in increased mortality risk of hypertension.
In general, high risks of hypertension prevail mostly in African-Americans in the U.S, and the efforts to curb this challenge are not quite sensitized. It is crucial to managing the socioeconomic, cultural, and physiological disparities in addressing the situation. The health care for the patients should be more aggressive and accessible, as well as more social support. Lowering BP can significantly reduce cardiovascular risks in high-risk patients. (Ferdinand & Nasser, 2017)
Evidence Type
The evidence for the above review is a research type. The evidence is based on findings from multiple studies by different individuals and organizations. Such kind of research with conclusions derived from facts obtained from numerous studies is meta-analysis research. Findings of the review are from surveys conducted by various organizations that included the Chicago Health Project, which studied perceived discrimination on individuals as a result of their race. Another organization was the Genetics of Hypertension Associated Treatments, which explored gene polymorphism; they considered the relationships between hypertension genes and health changes. Studies by Jackson Heart Study and Reasons for Geographic and Racial Differences in Stroke (REGARDS) revealed high mortality rates among the blacks as a result of hypertension. The recommendations address the high cases of hypertension among the African-Americans. All the suggestions are from various studies conducted randomly by different organizations on hypertension in African-Americans; therefore, the evidence is of high quality.
Reference
Maraboto, C., & Ferdinand, K. C. (2019). Update on hypertension in African-Americans. Progress in Cardiovascular Diseases, 63(1), 33-39. Doi:10.1016/j.2019.12.002
Ferdinand, K. C., & Nasser, S. A. (2017). Management of Essential Hypertension. Cardiology Clinics, 35(2), 231-246. Doi:10.1016/j.2016.12.005