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Systemic hypertension in blacks: an overview of current concepts of pathogenesis and management

S A Isezuo1

  • 1Department of Medicine, Usmanu Danfodiyo University Teaching Hospital, P.M.B. 2370, Sokoto, Nigeria. sisezuo@skannet.com

The Nigerian Postgraduate Medical Journal
|December 25, 2003
PubMed

Insights

Systemic hypertension in Black populations is significantly influenced by salt-sensitivity, leading to increased cardiovascular risks. Management challenges stem from socioeconomic factors, genetic predispositions, and lifestyle-related diseases.

Area of Science:

  • Cardiology
  • Public Health
  • Genetics

Background:

  • Systemic hypertension is a primary risk factor for cardiovascular disease in Black individuals.
  • Essential hypertension in this demographic is strongly linked to salt-sensitivity.
  • Multiple interactive mechanisms, including volume changes and nitric oxide inactivation, contribute to salt-sensitivity.

Purpose of the Study:

  • To review the unique factors influencing hypertension in Black populations.
  • To discuss the implications of these factors on the management of Black hypertensives.
  • To highlight the interplay of genetic, lifestyle, and socioeconomic determinants.

Main Methods:

  • Literature review of studies on hypertension in Black populations.
  • Analysis of physiological and genetic mechanisms of salt-sensitivity.
  • Examination of socioeconomic and lifestyle influences on cardiovascular health.

Main Results:

  • Salt-sensitivity is a dominant factor in essential hypertension among Blacks.
  • Factors such as ignorance, poverty, late diagnosis, genetic predispositions, and co-existing conditions (diabetes, obesity) exacerbate hypertension.
  • A 'western' lifestyle contributes to obesity and diabetes, worsening hypertensive outcomes.

Conclusions:

  • The management of hypertension in Black individuals requires addressing complex, multifactorial influences.
  • Understanding genetic and lifestyle factors is crucial for effective treatment strategies.
  • Socioeconomic determinants and co-morbidities significantly impact morbidity and mortality in Black hypertensives.

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