Prevention and Management of Hypertension among Blacks
Abstract
Research done over time has shown that hypertension among blacks is prevalent. It is evident from several types of research done that more African American men are exposed to hypertension compared to other races. Such health outcome is associated with several factors. They include socioeconomic factors, barriers to access to appropriate health care and mostly because of a genetic predisposition for high blood pressure.
A study done focusing on recognition of hypertension in older persons reveal that; hypertension is the most commonly diagnosed illness among persons over the age of 60. Hypertension is also associated with other several chronic diseases such as cardiovascular diseases. These diseases include heart failure, stroke and ischemic heart disease (Peters & Flack, 2016).
Studies have been done on prevention and management of hypertension, and some of them have proved to be valid to the rest of the populations, but unfortunately, more has to be done for the African American community. This study will focus on various strategies for early detection or recognition of hypertension among blacks as it also occurs in the first ages for them compared to other races (Huntley & Heady, 2013). Blood sugar level reduction has been an appropriate mechanism designed for the blacks to minimize the mortality rate and morbidity of cardiovascular disorders stemming from hypertension.
Most researchers have recommended the use of thiazide diuretics and calcium channel blockers after careful evaluation of the sick, for the initial drug therapy process. The study will focus on the management and prevention of hypertension among the elderly African American population. This is because the age, from 60 years and above, and mostly blacks are categorized as high-risk groups. The study will seek to understand the problems associated with previously advised recommendations and why they failed to achieve intended purpose.
Theoretical Framework
Salt sensitivity
This theoretical framework indicates that there is a linear relationship between salt sensitivity and age. There are various categories, specifically five, associated with salt sensitivity and these include social and racial factors, demographic factors, dietary habit factors, hormonal factors and renal function factors. The study further concluded that a direct and positive relationship exists between salts sensitivity and age (Fox et al., 2011).
This means that salt sensitivity escalates as an individual continues aging or getting older. The increased salt sensitivity among African-Americans has been proven through using i.v. NaCl loading alongside using dietary sodium designs (Peters & Flack, 2016).
Cooper et al. attempted to disassociate the environmental, social, and genetic aspects of race through studying sodium intake and hypertension within populations of the Africans in Diaspora. Seven populations originating from West African revealed a regressive rise in prevalence of hypertension from 33% in U.S to 26% in the Caribbean and 16% in West Africa.
The study unveiled strong cross-cultural relations of high blood pressure risk based on social-environmental aspect and intake of sodium-potassium responsible for approximately 70% of the geographic variation in prevalence of hypertension. However, the report failed to discuss the psychosocial factors that dumbfound the hypertension risk among the subjects (Huntley & Heady, 2013).
It should also be noted that in this study, the prevalence rate of hypertension in West Africa is lower compared to that for Caucasians in the U.S. The findings show the profound essence of environmental exposure in salt sensitivity development among patients. Therefore, it is quite debatable the racial reason behind high prevalence of hypertension among blacks in the US environment, but the concept of high salt sensitivity among the older people remains unaltered (Sandra, 2016).
Diagnostic Approach
A general evaluation of the population to be investigated is done. A thorough clinical assessment is conducted and includes initial and periodic orthostatic blood pressure measurement among older black adults. It involves closer investigation and analysis of historical data of the patient (Still, Ferdinand, Ogedegbe, & Wright, 2015). In the process, it is also essential to enquire about factors that may impact prognosis and therapy of the patient ranging from lifestyle behaviors to socioeconomic status, to psychosocial and also environmental factors.
Lifestyle Modifications
This includes dietary modification, weight reduction, and increased physical activity. They were particularly significant in the treatment of old African Americans as both primary and secondary level of interventions considering the high prevalence of obesity in this group (Still, Ferdinand, Ogedegbe, & Wright, 2015).
Research Questions
- How effective is the diagnostic approach of preventing hypertension among the older African American population?
- How can the prevalence be controlled among the aged and are the interventions appropriate?
Target population
The target population entails the hypertensive African-American over the age of 60, and the population will be selected through sampling method.
Research Design
The study design adopted by this study is descriptive and will focus on management and prevention of hypertension among the elderly blacks over age 60 years. The main aim of using a descriptive design is to carry out a survey of randomly selected individuals that fit the sample criteria identified for this study. In addition to this, research articles will be used to determine the methods prescribed and their effectiveness.
The data will be collected from 50 homes of African Americans from every region. However, the validity of data gathered from the survey may limit the scope of this research regarding full details. The other factor includes researcher biases that restrict objectivity in the study. This is because of the time limit factor that prevents considering the whole population.The threats identified above can be addressed through the use of more respondents in future studies and use of patient records in the hospital after seeking the patient’s consent. To minimize biases then proper and non-prejudgment approach will be employed.
Sample
The sample size is 50 hypertensive patients within the states. The selection method of participants is through convenience sampling. The representatives of this study involve willing and able participants in the study which improves the reliability of data provided by them for the study. The threats identified include; individuals selected may provide unreliable or tailored responses to the questionnaires used during the survey.
The sample size is reliable within the time framework provided and is a good representation of the whole population. However, for a more reliable data, a larger sample size is recommended for the research. The information or any data obtained from the patient will be treated with confidentiality, and patient anonymity will be maintained as per the regulations of the IRB. Written consent will be signed by the then patient without revealing any identity and filed before filling out the questionnaire.
Methods
Within this research, several variables underlying the prevention and management of hypertension can be seen. This includes the dependent variable as the prevalence of hypertension and the independent variables which include lifestyle modifications and proper interventions such as the primary, secondary and tertiary interventions as mentioned above. They are the strategies employed towards preventing and managing high blood pressure (Peters & Flack, 2016).
References
Fox, E., Young, J., Keating, B., Li, Y., Dreisbach, A., & Musani, S. et al. (2011). Association of genetic variation with systolic and diastolic blood pressure among African Americans: the Candidate Gene Association Resource study. Human Molecular Genetics, 20(11), 2273-2284. http://dx.doi.org/10.1093/hmg/ddr092
Huntley, M., & Heady, C. (2013). BARRIERS TO HEALTH PROMOTION. A CASE OF AFRICAN AMERICAN MEN WITH HYPERTENSION. American Journal of Health Studies, 28(1).
Peters, R. and Flack, J. (2016). Salt Sensitivity and Hypertension in African Americans. [online] Medscape. Available at: http://www.medscape.com/viewarticle/407741_3
Sandra, A.M., (2016). Hypertension in African Americans & its related chronic diseases.-PubMed – NCBI. Ncbi.nlm.nih.gov. Retrieved 22 October 2016, from https://www.ncbi.nlm.nih.gov/pubmed/20069804
Still, C., Ferdinand, K., Ogedegbe, G., & Wright, J. (2015). Recognition & Management of Hypertension in Older Persons: African Americans. Journal of The American Geriatrics Society, 63(10), 2130-2138. http://dx.doi.org/10.1111/jgs.13672
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