Skip to main content
SpringerLink
Log in

A Attitudes Regarding Hypertension Among Older African-American Adults

  • Chapter
Hypertension in the Elderly

Part of the book series: Clinical Hypertension and Vascular Diseases ((CHVD))

  • 781 Accesses

Abstract

Before hypertension can be effectively treated in older African-American patients, the clinician must become familiar with the attitudes of this population regarding this disease. One of the major barriers to effective antihypertensive therapy is having a clinician who is not aware of potential impact that patient attitudes have on compliance with office visits and pharmacological therapy. One group of investigators did a survey of African Americans, Hispanic Americans, and non-Hispanic white adults over the age of 75 years that assessed ethnic differences in perceptions regarding the cause, prevention, and treatment of hypertension as well as associations between perceptions and the use of preventive health services (1). The survey found that African Americans felt that hypertension resulted from poor health behaviors and stress, but that it was both preventable and treatable. In contrast, non-Hispanic whites felt that hypertension is a result of various mechanistic causes and heredity; also, they felt hypertension was treatable but not preventable. Finally, Hispanic Americans were more likely to state that hypertension was the result of aging and poor health behaviors and was not susceptible to treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Ontiveras JA, Black SA, Jakobi PL, Goodwin JS. Ethnic variation in attitudes toward hypertension in adults ages 75 and older. Prev Med 1999;29:443–449.

    Article  Google Scholar 

  2. The ALLHAT Collaborative Research Group. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: the Antihypertensive and Lipid-Lo wering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA 2002;288:2981–2997.

    Article  Google Scholar 

  3. SHEP Cooperative Research Group. Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. JAMA 1991;265: 3255–3264.

    Article  Google Scholar 

  4. Moser M. Treatment of hypertension in the very elderly: a clinician’s point of view. J Clin Hypertens (Greenwich) 2003;5:310–312.

    Google Scholar 

  5. Wright JT, Douglas J. Optimal treatment of hypertension and cardiovascular risk reduction in African-Americans: treatment approaches for outpatients. J Clin Hypertens (Greenwich) 2003;5(1 suppl 1): 18–25.

    Article  Google Scholar 

  6. Messerli FH, Grossman E, Lever AF. Do thiazide diuretics confer specific protection against strokes? Arch Intern Med 2003;163:2557–2560.

    Article  PubMed  CAS  Google Scholar 

  7. Pitt B, Zannad F, Remme WJ, et al. for Randomized Aldactone Evaluation Study Investigators. The effect of spironolactone on morbidity and mortality in patients with severe heart failure. N Engl J Med 1999;341:709–717.

    Article  PubMed  CAS  Google Scholar 

  8. Chobanian AV, Bakris GL, Black HR, et al. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA 2003;289:2560–2571.

    Article  PubMed  CAS  Google Scholar 

  9. Pitt B, Remme W, Zannad F, et al. Eplerenone, a selective aldosterone blocker, in patients with left ventricular dysfunction after myocardial infarction. N Engl J Med 2003;348:1309–1321.

    Article  PubMed  CAS  Google Scholar 

  10. Flack JM, Oparil S, Pratt JH, Roniker B, et al. Efficacy and tolerability of eplerenone and losartan in hypertensive black and white patients. J Am Coll Cardiol 2003;41:1148–1155.

    Article  PubMed  CAS  Google Scholar 

  11. Agodoa LY, Appel L, Bakris GL, et al. Effect of ramipril vs amlodipine on renal outcomes in hypertensive nephrosclerosis. A randomized controlled trial. JAMA 2001;285:2719–2728.

    Article  PubMed  CAS  Google Scholar 

  12. The Heart Outcomes Prevention Evaluation Study Investigators. Effects of an angiotensin-converting enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. N Engl J Med 2000;342:145–153.

    Article  Google Scholar 

  13. Saunders E, Gavin JR 3rd. Blockade of the renin-angiotensin System in African-Americans with hypertension and cardiovascular disease. J Clin Hypertens (Greenwich) 2003;5:12–17.

    Article  Google Scholar 

  14. Svensson P, de Faire U, Sleight P, et al. Comparative effects of ramipril on ambulatory and office blood pressures. A HOPE substudy. Hypertension 2001;38:e28–e32.

    Article  PubMed  CAS  Google Scholar 

  15. Materson BJ, Reda DJ, Cushman WC, et al. Single-drug therapy for hypertension in men. A comparison of six antihypertensive agents with placebo. N Engl J Med 1993:328:914–921.

    Article  PubMed  CAS  Google Scholar 

  16. Saunders E, Weir M, Kong BW, et al. A comparison of the efficacy and safety of a β-blocker, a calcium channel blocker, and a converting enzyme inhibitor in hypertensive blacks. Arch Intern Med 1990;150:1707–1713.

    Article  PubMed  CAS  Google Scholar 

  17. Materson BJ, Reda DJ, Williams D, for the Department of Veterans Affairs Cooperative Study Group on Antihypertensive Agents. Lessons from combination therapy in Veterans Affairs Studies. Am J Hypertens 1996;9:187S–191S.

    Article  PubMed  CAS  Google Scholar 

  18. Douglas JG, Bakris GL, Epstein M, et al. Management of high blood pressure in African-Americans. Consensus statement of the Hypertension in African-Americans Working Group of the International Society on Hypertension in Blacks. Arch Intern Med 2003;163:525–541.

    Article  PubMed  Google Scholar 

  19. Brown NJ, Ray WA, Snowden M, Griffin MR. Black Americans have an increased rate of angiotensin converting enzyme inhibitor-associated angioedema. Clin Pharmacol Ther 1996;60:8–13.

    Article  PubMed  CAS  Google Scholar 

  20. Elliott WJ. Higher incidence of discontinuation of angiotensin enzyme inhibitors due to cough in black subjects. Clin Pharmacol Ther 1996;60:582–588.

    Article  PubMed  CAS  Google Scholar 

  21. PROGRESS Collaborative Group. Randomized trial of a perindopril-based blood-pressure-lowering regimen among 6105 individuals with previous stroke or transient ischemic attack. Lancet 2001;358:1033–1041.

    Article  Google Scholar 

  22. Johnson WR, Saunders E, Jones-Burton C: Hypertension in African-Americans. In Egan BM, Basile JN, Lackland DT, eds. Hot Topics in Hypertension. Philadelphia: Hanley and Belfus; 2004: 406–407.

    Google Scholar 

  23. Wright JT Jr, Bakris G, Greene T, et al. Effect of blood pressure lowering and antihypertensive drug class on progression of hypertensive kidney disease: results from the AASK trial. JAMA 2002;288:2421–2431.

    Article  PubMed  CAS  Google Scholar 

  24. Dahlof B, Devereux RB, Kjeldsen SE, et al. Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomized trial against atenolol. Lancet 2002;359:995–1003.

    Article  PubMed  CAS  Google Scholar 

  25. Lewis EJ, Hunsicker LG, Clarke WR, et al. Renoprotective effect of the angiotensin-receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetes. N Engl J Med 2001;345:851–860.

    Article  PubMed  CAS  Google Scholar 

  26. Brenner BM, Cooper ME, De Zeeuw D, et al. Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy. N Engl J Med 2001;345:861–869.

    Article  PubMed  CAS  Google Scholar 

  27. Kaperonis N, Bakris G. Blood pressure, antihypertensive therapy and risk for renal injury in African-Americans. Curr Opin Nephrol Hypertens 2003;12:79–84.

    Article  PubMed  Google Scholar 

  28. Hostetter TH. Editorial. N Engl J Med 2001;345:910–912.

    Article  PubMed  CAS  Google Scholar 

  29. Saunders E. Benefits of calcium channel antagonists in controlling hypertension in African-American patients: factors in drug selection. ABC Digest Urban Cardiol 1999;6:11–15.

    Google Scholar 

  30. Weir MR. Population characteristics and the modulation of the renin-angiotensin system in the treatment of hypertension. J Hum Hypertens 1997;11:17–21.

    Article  PubMed  CAS  Google Scholar 

  31. Krieger N, et al. Discrimination in African-Americans: the effect on the incidence of hypertension. Am J Pub Health 1996;86:1370–1378.

    Article  PubMed  CAS  Google Scholar 

  32. Leonetti G. The effects of calcium antagonists on electrolytes and water balance in hypertensive patients. J Cardiovasc Pharmacol 1994;24(suppl A):S25–S29.

    PubMed  Google Scholar 

  33. Redon J, Lozano JV, de la Figuera M, et al. Do changes in dietary influence blood pressure of hypertensive patients pharmacologically controlled with verapamil? The Salt-Switching-Study (SSS). J Hum Hypertens 1995;9:143–147.

    PubMed  CAS  Google Scholar 

  34. Houston MC, Weir MR, Gray J, et al. The effects of nonsteroidal anti-inflammatory drugs on blood pressures of patients with hypertension controlled by verapamil. Arch Intern Med 1995;155:1049–1054.

    Article  PubMed  CAS  Google Scholar 

  35. Krishna GC, Riley LJ, Deuter G, et al. Natriuretic effect of calcium-channel blockers in hypertensives. Am J Kidney Dis 1991;18:566–572.

    PubMed  CAS  Google Scholar 

  36. Pepine CJ, Handberg EM, Cooper-Dehoff RM, et al. A calcium antagonist vs a non-calcium antagonist hypertension treatment strategy forpatients with coronary artery disease. The International Verapamil-Trandolapril Study (INVEST): a randomized controlled trial. JAMA 2003;290:2805–2816.

    Article  PubMed  CAS  Google Scholar 

  37. The Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood pressure. National Institutes of Health; National Heart, Lung, and Blood Institute; National High Blood Pressure Education Program. November 1997. NIH Publication No. 98-4080.

    Google Scholar 

  38. Bakris GL, Dworkin WH, Elliott WJ, et al. Preserving renal function in adults with hypertension and diabetes; a consensus approach. National Kidney Foundation Hypertension and Diabetes Executive Committee Working Group. Am J Kidney Dis 2000;36:646–661.

    PubMed  CAS  Google Scholar 

  39. Chobanian AV, Bakris GL, Black HR, et al. Joint National Committee on Prevention, Detection, Evaluation, and Treatment of high Blood Pressure. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and treatment of High Blood Pressure. Hypertension 2003;42:1206–1252.

    Article  PubMed  CAS  Google Scholar 

  40. Bakris GL, Williams M, Dworkin L, et al. Preserving renal function in adults with hypertension and diabetes: a consensus approach. Am J Kidney Dis 2000;36:646–661.

    PubMed  CAS  Google Scholar 

  41. Kaplan NM. Clinical Hypertension. 7th ed. Baltimore, MD: Williams and Wilkins; 1998:210–211.

    Google Scholar 

  42. A trial of the β-blocker bucindolol in patients with advanced chronic heart failure. N Engl J Med2001;344:1659–1667.

    Google Scholar 

  43. Feuerstein G, Yue TL, Ma X, Ruffolo RR. Novel mechanisms in the treatment of heart failure: inhibition of oxygen radicals and apoptosis by carvedilol. Prog Cardiovasc Dis 1998;41(1 suppl 1):17–24.

    Article  PubMed  CAS  Google Scholar 

  44. Yancy CW, Fowler MB, Colucci WS, et al. Race and the response to adrenergic blockade with carvedilol in patients with chronic heart failure. N Engl J Med 2001;344:1358–1365.

    Article  PubMed  CAS  Google Scholar 

  45. Flamenbaum W, Weber MA, McMahon FG, et al. Monotherapy with labetalol compared with propanolol: differential effects by race. J Clin Hypertens 1985;1:56–69.

    PubMed  CAS  Google Scholar 

  46. Jacob S, Rett K, Wicklmayr M, et al. Differential effect of chronic treatment with two beta-blocking agents on insulin sensitivity: the carvedilol-metoprolol study. J Hypertens 1996;14:489–494.

    Article  PubMed  CAS  Google Scholar 

  47. Giugliano MD, Acampora R, Marfella R, et al. Metabolic and cardiovascular effects of carvedilol and atenolol in non-insulin-dependent diabetes mellitus and hypertension: a randomized, controlled trial. Ann Intern Med 1997;126:955–959.

    PubMed  CAS  Google Scholar 

  48. Sudhir K, Forman A, Yi SL, et al. Reduced dietary potassium reversibly enhances vasopressor response to stress in African-Americans. Hypertension 1997;29:1083–1090.

    PubMed  CAS  Google Scholar 

  49. UK Prospective Diabetes Study Group. Efficacy of atenolol and captopril in reducing risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 39. BMJ 1998;317:713–720.

    Google Scholar 

  50. Kountz DS. Cost containment for treating hypertension in African-Americans: impact of a combined ACE-inhibitor-calcium channel blocker. J Natl Med Assoc 1997;89:457–460.

    PubMed  CAS  Google Scholar 

  51. Ferdinand KC. Recommendations for the management of special populations: racial and ethnic populations. Am J Hypertens 2003;16(11 pt 2):50S–54S.

    Article  PubMed  Google Scholar 

  52. Messerili FH, Oparil S, Feng Z. Comparison of efficacy and side effects of combination therapy of angiotensin-converting enzyme inhibitor (benazepril) with calcium antagonist (either nifedipine or amlodipine) vs high-dose calcium antagonist monotherapy for systemic hypertension. Am J Cardiol 2000;86:1182–1187.

    Article  Google Scholar 

  53. Jamerson KA, Bakris GL, Douglas JG, et al. Design of the ACCOMPLISH (Avoiding Cardiovascular Events Through Combination Therapy in Patients Living With Systolic Hypertension) trial [abstract P-431]. Am J Hypertens 2003;16:193A.

    Article  Google Scholar 

  54. Jamerson KA. The first hypertension trial comparing the effects of two fixed-dose combination therapy regimens on cardiovascular events: Avoiding Cardiovascular Events Through Combination Therapy in Patients Living With Systolic Hypertension (ACCOMPLISH). J Clin Hypertens 2003;5(4 suppl 3):29–35.

    Article  Google Scholar 

  55. Lincoln C. Race, religion, and the Continuing American Dilemma. New York: Hill and Wang; 1984.

    Google Scholar 

  56. Koenig H. The Healing Power of Faith. New York: Simon and Schuster; 1999.

    Google Scholar 

  57. Walker CC, Kong BW, Benjamin TG, Ofili EO. The Healing Power of Faith. ABC Digest Urban Cardiol 2002;9:8–16.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Section of Hypertension, University of Maryland School of Medicine, Baltimore, MD

    Wallace R. Johnson Jr. MD & Elijah Saunders MD

Authors
  1. Wallace R. Johnson Jr. MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Elijah Saunders MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Medical College of Georgia, Augusta, GA

    L. Michael Prisant MD

Rights and permissions

Reprints and permissions

Copyright information

© 2005 Humana Press Inc., Totowa, NJ

About this chapter

Cite this chapter

Johnson, W.R., Saunders, E. (2005). A Attitudes Regarding Hypertension Among Older African-American Adults. In: Prisant, L.M. (eds) Hypertension in the Elderly. Clinical Hypertension and Vascular Diseases. Humana Press. https://doi.org/10.1007/978-1-59259-911-0_21

Download citation

  • DOI: https://doi.org/10.1007/978-1-59259-911-0_21

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-197-4

  • Online ISBN: 978-1-59259-911-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation