prevalence of hypertension

Racial Disproportionality and Hypertension

Racial disproportionality is a well-known concept in the incidence of hypertension, with African Americans being connected with higher vulnerability, premature deaths, and an increased chance of blood pressure-related problems. The disparities have inspired the need for a greater focus, with biological variances, environmental variables, and behavioral factors identified as key drivers in the varied prevalence.

Genetics and Hypertension

While the factors can directly raise susceptibility to hypertension and related consequences, they largely work via activating physiological mechanisms that predispose African Americans. Genetics is one of the most explored causes, with Kaplan & Flynn (2006) noting that 18 genotypes, as well as phenotypes, are responsible for the elevated risk among blacks. The view was also echoed by Michaud (2009) in his suggestion that aberrations of the MYH9 region on chromosome 22 contribute to glomerulosclerosis focal segmental. The condition is anecdotally linked to hypertensive nephrosclerosis, which is more frequent among Blacks, as reported by Kopp et al. (2008) that MYH9 haplotype is present in 74% of African Americans while only 4% of European Americans carry the chromosomal aberration. The role of genetics in the high prevalence of hypertension among blacks is elaborated by Klein (2011) where the complete genomic used in the study revealed missense mutations in the APOL1 gene among patients with focal segmental glomerulosclerosis.

Behavioral and Environmental Factors

Another underlying element in the elevated risk is behavioral and environmental risks among blacks, which accounts for the differential prevalence of hypertension. Some of the research-documented aspects are dietary habits, health behaviors, nutritional issues, as well as socioeconomic status. The contribution of the factors is best exemplified by adiposity, which increases the risk among African Americans by 51% when compared to their white counterparts (Wee et al., 2008).

References

Kaplan, N. & Flynn, J. (2006). Kaplan’s clinical hypertension (1st ed.). Philadelphia: Lippincott Williams & Wilkins.

Klein, M. (2011). A risk allele for focal segmental glomerulosclerosis in African Americans is located within a region containing APOL1 and MYH9. Yearbook Of Medicine, 2011, 197-198. http://dx.doi.org/10.1016/j.ymed.2011.08.059

Michaud, J. (2009). Polymorphisms in the non-muscle myosin heavy chain 9 gene (MYH9) are strongly associated with end-stage renal disease historically attributed to hypertension in African Americans. Yearbook Of Medicine, 2009, 246-247. http://dx.doi.org/10.1016/s0084-3873(09)79367-8

Wee, C., Mukamal, K., Huang, A., Davis, R., McCarthy, E., & Mittleman, M. (2008). Obesity and C-reactive Protein Levels Among White, Black, and Hispanic US Adults. Obesity. http://dx.doi.org/10.1038/oby.2008.146

Kopp, J. B., Smith, M. W., Nelson, G. W., Johnson, R. C., Freedman, B. I., Bowden, D. W., & Berns, J. S. (2008). MYH9 is a major-effect risk gene for focal segmental glomerulosclerosis. Nature genetics, 40(10), 1175-1184.