The puzzle of hypertension in African Americans

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The puzzle of hypertension in African Americans
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• Age goes ? so does blood pressure
• Hypertension High Blood pressure
• Part of heart disease, strokes, kidney failure
• They kill 500 k/year
• Risk factors overweight, high salt diet, long
  term mental stress, physically inactive, drinking
  alcohol to excess
• Overweight Pets ?

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• Cause of death for
• 10 of whites
• 20 of blacks
• WHY THE DISPARITY?

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• Are people of African Descent more susceptible?
• Is it race or another variable?
• Is it genetic?
• What does the evidence show?
• BE CAREFUL OF OVERSIMPLIFICATION

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Another way to look at it

• Hypertension results from
• Complex interaction of
• Stress/diet, physiology, and genetics
• Better understanding of causes better treatment

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• If you hold genetic background of people in
  distinct environments constant
• You can focus on variations in living conditions
  and behavior
• Cant be perfect because everyone has some of the
  risk factors

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• Look to Africa
• Rural West Africa has the lowest rate of
  hypertension in the world.?
• How can people of African descent in US and UK
  have some of the highest rates ?
• This is evidence that it is not genetic. That it
  is because of way of life.

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Americans Jamaicans in study 75 genetically
similar to Nigerians

• BMIs over 25 overweight
• Overweight, unexercised, poor diet explains 40
  -50 of the risk for h. tension African Americans
  face compared with Nigerians

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• Will the rate of hypertension increase for any
  group that lives a modern lifestyle?
• Within Nigeria people living in Nigerian cities
  have higher B.P. than rural Nigerians, but the
  two groups are similar on BMI and Salt intake
• Whats dif. Between city and country?
• Stress and exercise plays a part.
• What does this say about mans evolutionary
  history?

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• Are there stresses blacks in N. America and
  Europe face that blacks in Africa do not?
• Racism?
• Does racism affect blood pressure?
• In Trinidad and Cuba black, spanish, and white
  rates of similar B.P. levels
• Do they have better race relations?

Havana Bay
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The environment at work

• Kidneys play a part in B.P.
• They control salt (sodium) levels in blood
• They keep 98 of it.
• Sodium was once very precious in our diet
• Too much sodium raises B.P.
• DONT EAT TOO MUCH SALT

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• FDA's recommended daily value of sodium is 2,400
  mgs, about a teaspoon
• Department of Health and Human Services'
  recommends no more than 1,500 per day for adults
  middle-aged or older
• Really the average daily intake of salt is more
  like 3,400 mg

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McDonalds
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Questions

• Was this an experiment or a study?
• What are the pitfalls or dangers of investigating
  this topic?
• Reducing humans to fictitious inherent
  differences in race.
• What does the dif. in B.P. suggest about human
  evolution?
• We developed in a low sodium diet environment,
  thats what were built for.
• What is the role of environment?
• What is the role of genetics?
• What is the strongest/weakest evidence?
• What was the sample size?
• They dont say here, but they do site where you
  could read up on their study.

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Who Wrote this article?

• Epidemiologists
• Richard Cooper, from Loyola
• Charles Rotimi, from Nigeria, now working for
  Human Genome project
• Ryk Ward, British guy, round the world type

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And what about Michael Jackson?