[Arterial hypertension in the black race]

Hypertension represents a major health problem for black populations living in Western countries. In particular, blacks living in the United States have a three- to fivefold greater mortality from hypertensive disease than do whites. Better knowledge of the pathophysiology of hypertension in blacks can aid in the treatment of recently urbanized black people coming to Italy from African countries. Hypertension occurs more frequently in blacks than in whites, due to increased volemia; this characteristic seems to be related to a genetically determined increase in sodium sensitivity. Environmental factors seem to play a relevant role. Several studies performed on blacks migrating from rural to urban areas both in Africa and the USA, have shown that urbanization is closely related to increased blood pressure. The occurrence of cardiac and cerebrovascular complications of hypertension also seems to be closely related to socioeconomic factors. In fact, recently immigrated black people often lack health care facilities and consequently have poor control of hypertension. The environmental factors could be overcome by implementing systems to improve health care facilities, in particular blood pressure control, for recently urbanized blacks.