Afro-Caribbeans Need to be Extra Vigilant about Hypertension
By Joy Stephenson-Laws, JD, Founder
People of Afro-Caribbean descent – whether they live in the islands or in other parts of the world – experience higher rates of hypertension compared to other populations. In this regard, they mirror African-American adults in the United States, with both groups having hypertension that occurs earlier in life and with more serious consequences, including organ damage to the heart, eyes and kidneys as well as heart attacks, strokes, cognitive limitations and late-stage kidney disease.
To give you an idea of how serious a health problem this is, health authorities report that worldwide hypertension is responsible for 51 percent of deaths due to stroke and 45 percent of deaths due to heart disease. These two diseases also are the leading causes of death in the Caribbean.
Twenty-five percent of deaths in the Caribbean are related to cardiovascular disease. And hypertensive disease is the fifth leading cause of death in that region. Some estimates are that some 21 percent of adults in Trinidad and Tobago and Barbados are hypertensive; this number climbs to around 25 percent in Jamaica; and up to between 35 and 38 percent in St. Kitts, the British Virgin Islands and Granada. There is even evidence that this number may actually be closer to 55 percent of those over 40 years of age across the region.
These are eye-opening numbers that should get the attention of anyone of Afro-Caribbean heritage!
Unfortunately, there has been very little research to understand why the Afro-Caribbean population has such alarmingly high rates of hypertension and related diseases. To that end, one study at the Yale School of Medicine aims to determine which factors are contributing to the high number of poor cardiovascular outcomes in the Caribbean. The study is part of a larger research project that is focusing on Trinidad and Tobago, Barbados, Puerto Rico and the U.S. Virgin Islands. Other studies are also underway which are looking at the causes and effects of hypertension in other parts of the region.
In the ongoing Yale study, the researchers are looking at both biological factors, such as genetics, and social and environmental factors. The hope is that by better understanding why hypertension is so rampant among this group, that more effective prevention and management programs may be developed.
Some possible theories being investigated include stress levels, since high rates of stress can contribute to elevated blood pressure and its resulting cardiovascular health issues. They are also looking for indications of “masked hypertension,” which is when a patient whose blood pressure is high during their normal daily life measures as normal when they visit their doctor or healthcare provider. This phenomenon is basically the opposite of the well-known “white coat syndrome,” which is when a person with otherwise normal blood pressure has high blood pressure in the doctor’s office. Another area they are studying is why some patients’ blood pressure does not drop when they are asleep, which is when blood pressure typically decreases.
Other research projects are studying the impact of salt sensitivity (how salt intake impacts blood pressure) in Afro-Caribbeans, and their results so far indicate that this group indeed does have higher salt-sensitivity than do others.
To give some reference, about 25 percent of people with normal blood pressure are salt sensitive but upward of 50 percent of those with hypertension are. Given the link between hypertension and kidney disease with black Caribbeans, salt sensitivity is very relevant to helping better prevent and manage their high blood pressure.
How to Be Proactive Now
Fortunately, if you’re of Afro-Caribbean descent, you don’t need to wait for the final research reports to be published to take steps now to see whether you have high blood pressure. You can manage high blood pressure if you have it or, even better, work to prevent it if you don’t.
Monitor your blood pressure.
This may seem pretty obvious, but research shows that between 35 percent and 40 percent of black Caribbeans living in the islands have no idea they have hypertension. This number is almost double the percentage of people who have high blood pressure in the US mainland and don’t know it. Given that high blood pressure usually has no symptoms – hence its moniker of “the silent killer” – having your blood pressure checked regularly is critical.
Also, since the blood pressure of many people of Afro-Caribbean descent may not decrease during the night, you may also want to ask your healthcare provider about doing a 24-hour blood pressure monitoring test. To do this, you simply wear a blood pressure cuff that will automatically measure your blood pressure every half hour over 24 hours. You can also test and keep track of your blood pressure with a home monitoring kit.
Be aware of your mineral levels.
For example, a zinc deficiency may cause you to have unhealthy blood pressure levels.
Reduce salt intake.
Since research suggests that Afro-Caribbeans have higher salt sensitivity, it’s important to check your diet and reduce or eliminate as much salt as possible. Other ingredients in many Afro-Caribbean diets, such as extra sugar, fats and calorie-dense nutrient-light foods also may contribute to high blood pressure as well, so you should eat them sparingly if it all.
Consider the DASH Diet.
(DASH stands for Dietary Approaches to Stop Hypertension). This approach to eating and nutrition is easy to follow, and you don’t need to buy anything that can’t be found at the local supermarket. It includes:
- Having a diet full of vegetables, fruits and whole grains
- Fat-free or low-fat dairy products, fish, poultry, beans, nuts and vegetable oils
- Limiting foods that are high in saturated fats, such as fatty meats, full-fat dairy products and tropical oils such as coconut or palm oil
- Limiting sweets and sugar-sweetened beverages
You can find more information about healthy eating and how diet can help manage hypertension by visiting the pH Labs blog section on nutrition.
Maintain a healthy body weight and body fat percentage.
Make sure you include enough physical activity in your daily routine.
It is also important to practice stress management; limit alcohol consumption; and get enough sleep.
Discuss appropriate medications with your doctor.
One other thing to keep in mind is that those of African-Caribbean descent may not respond as well to certain hypertension medications as do other groups. So, if you’re a member of this group and your doctor recommends medication, you may want to mention this. Also, keep in mind that many medications, including blood pressure medications, may deplete certain vitamins and minerals from your body. Working with your healthcare provider, you can easily compensate for this with diet or supplements from a reputable company.
Enjoy your healthy life!
The pH professional health care team includes recognized experts from a variety of health care and related disciplines, including physicians, attorneys, nutritionists, nurses and certified fitness instructors. This team also includes the members of the pH Medical Advisory Board, which constantly monitors all pH programs, products and services. To learn more about the pH Medical Advisory Board, click here.