(Royal Gazette) — There is a higher incidence of high blood pressure in blacks and it cannot be wholly attributed to cultural differences.
Ideas that blacks eat more fried food and suffer more stress than their white counterparts are inaccurate, but it is true that biologically hypertension is different in blacks.
Scientists are not sure why but the research does show hypertensive blacks are sensitive to salt (more specifically, the sodium in salt).
In fact the Hypertension Guidelines for Bermuda released late last year, give specific direction to doctors on medicine to prescribe for black patients.
According to the guidelines, hypertensive patients younger than 55 should first be prescribed an Ace inhibitor, examples include the generics; enalapril, ramipril, lisinopril and captopril and the brand names; Vasotec, Altace, Zestril and Capoten.
But this first line medication should not be used if the patient is black. And the guidelines are clear about who doctors should categorise as black.
“Black patients are those of African or Caribbean descent, and not mixed race, Asian or Chinese patients.
According to the guidelines, for all blacks with high blood pressure and those people of other races who are over 55 and hypertensive, the first line of medications should be either a calcium channel blocker or a thiazide-type diuretic.
Examples of generic calcium channel blockers include; amlodipine, diltiazem, felodipine, nifedipine, and verapamil.
Brand name examples of calcium channel blockers include; Norvasc, Cardizem, Plendil, Adalat and Calan.
As most blacks with hypertension have too much salt (sodium) in their blood, diuretics are a necessary treatment.
Salt in the body attracts water. Too much salt results in too much water in the bloodstream. This additional liquid results in a higher blood pressure and more work for the heart.
The kidneys filter out water, salts and waste products from the bloodstream. Most of the water and salts are reabsorbed into the blood while some is excreted as urine.
Diuretics work by reducing the amount of salt and water that are reabsorbed. This increases the amount of urine the body produces and decreases the amount of fluid left in the bloodstream.
The overall volume of blood is therefore reduced, which gives the heart less work to do and helps to reduce blood pressure.
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