The Puzzle of Hypertension in African-Americans; February 1999; Scientific American Magazine; by Cooper, Rotimi, Ward; 7 Page(s)

Nearly all Americans undergo a steady rise in blood pressure with age. Almost 25 percent cross the line into hypertension, the technical term for chronically high blood pressure. This condition, in turn, can silently contribute to heart disease, stroke and kidney failure and thus plays a part in some 500,000 deaths every year. For black Americans, the situation is even more dire: 35 percent suffer from hypertension. Worse, the ailment is particularly deadly in this population, accounting for 20 percent of deaths among blacks in the U. S.-twice the figure for whites.

One popular explanation of this disparity between blacks and whites holds that people of African descent are "intrinsically susceptible" to high blood pressure because of some vaguely defined aspect of their genetic makeup. This conclusion is not satisfying. Indeed, the answer troubles us, for as we will show, it does not reflect the available evidence accurately. Instead such reasoning appears to follow from the racialized character of much public health research, which at times defaults to reductionist interpretations that emphasize the importance of racial or genetic characteristics. Race becomes the underlying cause for the presence of a disease, rather than being recognized as a proxy for many other variables (along the lines of, say, socioeconomic status) that influence the course of a disorder.