An ecological view of hypertension in blacks

The prevalence of hypertension in blacks is higher than that of whites by all demographic variables. This might lead to the conclusion that there is a genetic basis for the disease. Prevalence differences among black populations in different geographic areas, however, point to environmental factors. An ecological hypothesis to explain the intake and retention of salt and the response to environmental stress as possible reasons for the interracial and intraracial prevalence differences are presented. Physicians may find this ecological approach of use in improving treatment of black hypertensive patients.