HTN in African American community

[Jayla]

I'm not a big daytime tv person, so I don't have a strong opinion about Oprah either way. The other day I happened to be watching her show, and she made a comment about HTN in African Americans that I have some issue with.

She said HTN is so prevalent in the AA community because those that live today are the descendants of Africans that were able to "retain salt and therefore water, so survived on the slave ships" when they were being brought to the Americas.

While this seems plausible to a certain degree, I think it negates a number of factors: rampant poverty in AA community (inability to afford healthy food like produce); lack of availability (in any given inner city neighborhood, where many AAs live, there are more fast food joints and fewer grocery stores with adequate healthy food selections); and most importantly, personal accountability. People choose to eat processed food high in salt and saturated fat content, and what this calls for is EDUCATION.

Not to mention most AA are not only descended from Africans, but a mix of European, Native American and Latin American.

In addition, many AA girls/women don't see themselves as fat when they really are overweight or obese. It's culturally acceptable, even desirable, to be overweight. While we don't want the opposite extreme (anorexia), we need to discourage extremes in either direction.

I feel like Oprah, and her "expert" physician, did a disservice to the AA community by making this comment without qualification. It leaves the average person thinking that their high blood pressure is out of their control, and therefore inevitable. What Americans (not just AA) as a whole need more of is a good dose of personal accountability for their own health.

I'll get off my soapbox--that was just really bugging me!

[birdgardner]

Those of us who are not AA should certainly TRY to understand for the sake of our AA patients.

I have HTN (hypertension for you, Dave). That's biology, genetic inheritance. I'm fortunate it's very well controlled because I have the resources and education to take my meds and ask my doctor to adjust them when needed, and I try to eat healthy and exercise so it doesn't get worse.

For many chronic diseases there is an interplay of biology, lifestyle (chosen) and situation (not chosen).The OP comes across as judgmental in dismissing biology. Some of us get a bad hand even when we do things right. But it is true that there are many factors that contribute that are controllable.

So how do nurses educate about those factors, and what understanding do they need working within a culture, or cross-culturally? If you want to get specific about AAs and HTN, what do we need there?

[blueheaven]

I know that where I live (large AA community) the very poor, indigent as well as the "well to do" have problems with HTN. Yes, some ppl may have obesity problems but this does not negate the fact that for some reason HTN is more prevelant in this ethnic group. I know that several of the nursing schools in the area here have done outreach into the community i.e inner city as well as 'burbs to educate people about medications, risk factor change etc. In the lower income areas here many folks depend on food banks, soup kitchens etc. in order to feed themselves as well as their families so choices are very limited to these folks as far as nutrition goes.

Medical care is also limited in the lower income (or no income) demographic.

I know this because I see all these things on an everyday basis and I work in my church's food pantry and soup kitchen when I can.