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AFRICAN AMERICANS WITH HIGHER INCOME AND EDUCATION LEVELS HAVE GREATER HIGH BLOOD PRESSURE AWARENESS AND CONTROL, NEW ANALYSIS SAYS
NEW YORK, NY -- African Americans with higher income and education levels are less likely to suffer the consequences of hypertension because of their awareness of the benefits of a heart healthy diet.
This new information, published in the September issue of the American Journal of Hypertension, also suggests that African Americans with lower income and education levels are more likely to ignore warnings about high blood pressure dangers and continue to eat foods containing too much salt, and to avoid heart healthy potassium-rich foods, such as fresh fruits and vegetables.
"The tendency to consume too much salt or sodium and not enough potassium is suspected to be an important contributing factor to hypertension," says Michael Weber, MD, an editor of the American Journal of Hypertension. "Salt is believed to increase blood pressure and exaggerate the problems of hypertension.
"Maintaining an adequate level of dietary potassium, especially when combined with a reduction in sodium intake," he continued, "may help decrease the serious complications of hypertension, which include heart attack, stroke and kidney failure."
Nearly 12 million African Americans have high blood pressure, called the silent killer because it prematurely ages the body's arteries often without warning. African Americans are more likely than other groups to suffer the consequences of hypertension.
In the new American Journal of Hypertension study, Mukul C. Ganguli, MVSc, PhD, of the University of Minnesota, and others examined baseline data from the Treatment of Mild Hypertension Study (TOMHS) to assess differences in the urinary excretion of sodium and potassium.
TOMHS was a multi-center, placebo-controlled clinical trial conducted between 1986 and 1988. It involved 902 men and women between the ages of 45 and 69 and was designed to compare six treatments for the long-term care of hypertension. All participants also received lifestyle advice involving weight loss, sodium and alcohol intake reduction and increased physical activity.
The authors of study, "Higher Education and Income Are Related to a Better Sodium to Potassium Ratio in Blacks," examined the urinary sodium and potassium ratios from 882 TOMHS participants -- 172 African Americans and 710 white.
"One way of testing the amount of salt and potassium in the diet is to measure the ratio of these substances in the urine," explains Dr. Weber. A high sodium to potassium ratio suggests a diet that could worsen the danger of hypertension while a low sodium to potassium ratio suggests a beneficial diet.
"The key finding by Ganguli et al was that within the African American population, those who had relatively higher incomes and levels of education had sodium and potassium ratios that were at least as good as those in well-educated and more affluent white patients," Dr. Weber said. The group of individuals with the most dangerous sodium to potassium ratios were black patients with the lowest incomes and poorest education.
"This finding is not entirely surprising," he continued. "In general, switching from high sodium to high potassium foods, a desirable dietary choice, generally requires buying more fresh produce and other foods that tend to be more expensive."
Dr. Weber also noted that people with poorer financial and educational resources may not get the same exposure to information about the benefits of maintaining a heart healthy diet.
"A critical lesson from the current research is the strong incentive to provide counseling to those patients who could potentially benefit from switching their diets," he said. "Thoughtful dietary advice could result in marked improvements in the intake of potassium and sodium without placing an unacceptable cost burden on these patients."
In addition to Dr. Ganguli, other study authors were Richard H. Grimm, Jr., MD, Kenneth H. Svendsen, MS, Gregory A. Grandits, MS, and Patricia J. Elmer, RD, PhD, University of Minnesota, Minneapolis, MN; and John M. Flack, MD, MPH, Bowman Gray School of Medicine, Wake Forest University, Winston Salem, NC.
The American Society of Hypertension is the largest US organization devoted exclusively to hypertension and related cardiovascular diseases. The organization is committed to alerting physicians, allied health professionals and the public about new medical options, facts, research findings and treatment choices designed to reduce the risk of cardiovascular disease.
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