Hypertension and African-Americans:
Proper medication and lifestyle changes could eliminate racial disparities in high blood pressure rates and complications

Kenneth Jamerson Photo: Marcia Ledford

Hypertension is not an equal opportunity disease. If you are African-American, everything about high blood pressure is more dangerous for you, says Kenneth Jamerson (M.D. 1986), an associate professor of internal medicine in the University of Michigan Medical School.

“When compared to other racial and ethnic groups in the U.S., African-Americans have much higher rates of high blood pressure,” says Jamerson, who serves as medical director for the U-M Health System’s Program for Multi-Cultural Health. “African-Americans tend to develop high blood pressure at an earlier age and are 18 times more likely than whites to develop kidney failure as a complication of the disease. Blacks make up only 12 percent of the U.S. population, but they are more than one-third of the patients in any renal dialysis clinic.”

The good news, according to Jamerson, is that it doesn’t have to be this way. He and another U-M physician, Axinlolu Ojo, studied 1,100 African-Americans with hypertension-induced kidney damage to determine which type of medication was most effective for them. They found that, with the right medication and lifestyle changes, the risk of kidney failure in African-Americans was no higher than in the rest of the population.

“Until recently, most physicians believed that diuretics, a class of drugs that helps you eliminate more urine from your kidneys, was the best therapy, but we found that was not the case,” Jamerson explains. Results from his study showed that blacks with high blood pressure and kidney damage benefited most from medications called angiotensin-converting enzyme (ACE) inhibitors, which help preserve kidney function by acting on hormones produced by the kidney.

“Scientists used to believe that blacks were genetically predisposed to develop high blood pressure,” Jamerson says. But a study called the African-American Study of Kidney Disease and Hypertension, conducted in part at the

U-M, has so far found little evidence of a genetic basis for high blood pressure in blacks. “Interestingly, what our results show is that blacks in the United States are genetically more similar to whites in the United States than they are to blacks in Africa,” Jamerson says.

“The bottom line advice for anyone with high blood pressure is to be in regular contact with your physician, because if an organ in your body is being damaged by high blood pressure, you won’t know it until it is too late,” Jamerson adds. “If you are African-American, the message is even more urgent.”

—SFP

U-M Health System’s African-American Cardiovascular Health Program: Learn how to prevent hypertension and what to do if you’ve been diagnosed with high blood pressure:
www.med.umich.edu/1libr/heart/afamer01.htm