Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: TUESDAY, April 24, 1990 TAG: 9004240153
SECTION: NATIONAL/INTERNATIONAL PAGE: A10 EDITION: METRO
SOURCE: The New York Times
DATELINE: LENGTH: Medium
"If there were no racism in America, hypertension would be less of a problem among blacks," said Dr. Elijah Saunders, a cardiologist at the University of Maryland Medical School and co-author of "Hypertension in Blacks" (Year Book Medical Publishers), a leading textbook in the field.
"Hypertension is at near-epidemic proportions among blacks and is chiefly responsible for their high mortality rates from heart and kindey disease and stroke."
"It makes sense to me that racism and black rage are emotional stressors that could worsen any physiological tendency toward hypertension," Saunders said.
Dr. Dean Ornish, director of a Sausalito, Calif. program for treating heart disease, recalls a patient he treated for hypertension. "He was on the faculty at Harvard, but when he went to Harvard Square to get a cab, no one would pick him up - because he was black.
"He was an hour late for his appointment with me. When I took his blood pressure, it was somewhere around 190/110, much higher than usual," said Ornish.
"He was angry, but it was a resigned anger, as if to say this was not the first time this had happened to him."
It is precisely that steady, subdued anger that many practicing physicians and a few scientific studies are now pointing to as a significant reason that hypertension, or high blood pressure, is twice as common in American blacks as whites.
But the evidence has yet to convince other experts.
"It's an intriguing idea, but it's difficult to attribute much of the hypertension in blacks to anger," said Dr. Clarence Grim, chief of the Hypertension Research Unit at the Martin Luther King Jr. Hospital in Los Angeles, who said he believed that genetic and physiological factors play the major role.
Federal health officials say the evidence is uncertain. "Folks have talked about anger and hypertension in blacks, but there are so many rival hypotheses about blacks' high blood pressure that it's hard to sort out exactly what's going on," said Dr. Ed Roccella, coordinator of the National High Blood Pressure Education Program of the National Heart, Lung and Blood Institute.
"So far as I know, there's not strong evidence either way yet."
The possibility that black anger about racism may account for a meaningful portion of the difference in rates of hypertension between blacks and whites, while intuitively sensible to some physicians, has been discounted by many scientists for lack of research evidence.
But in the last few years supporting evidence has grown, including several crucial studies published in the last year. Taken together they build a plausible scientific explanation for the higher incidence of hypertension among blacks.
Among major findings are these:
People who tend to suppress their anger, both black and white, have higher blood pressure than normal, as has been shown in dozens of studies over the years.
Some blacks appear to have a greater genetic or physiological susceptibility to high blood pressure than do whites.
Perhaps a quarter of all blacks retain sodium in their kidneys while under emotional stress, a reaction that raises the blood pressure, according to recent findings, some not yet published.
by CNB