Hypertension Editorial Is There a Black Hypertension?

IN the United States, blacks have a greater prevalence of essential hypertensionthan do whites.'~ * This difference is further accentuated by vital statistics data onmortality.5 Blacks have a threefold greater mortality from hypertensive diseases than do whites. This disproportionate mortality rises to more than six times greater in blacks than in whites in the age range of 35 to 54 years.5 Thus, the morbid consequence of hypertensive disease is severalfold greater in blacks, particularly in young to mid adulthood.6 This elementary public health statistic has not been acknowledged to a great extent by clinical and experimental investigators who distinguish between hy-pertension and normotension by hemodynamic, endocrine, and metabolic parameters. One explanation for this has been the following: The extent and severity of hyperten-sion in blacks are related to limited access to health care and attendant social and economic problems. As a largely social issue, these factors do not enter into the basic equation, blood pressure (BP) = flow (F) X resistance (R). The social, economic, and public health issues have been disregarded in the face of the complexity of the biological factors that affect the right side of this equation. Issues such as aging, genetics, and environment alter the biological interaction of the systems involved in blood pressure regulation. Consequently, studies that compar