Hypertension in the African Caribbean population

High blood pressure (hypertension) – very common in the UK – contributes to around half of all heart attacks and strokes in the UK. More than 14 million adults are diagnosed with the condition, plus as many as a further 5 million, who are thought to be undiagnosed. Blood pressure levels are consistently higher amongst people of African Caribbean descent, compared to their White counterparts, contributing to an earlier onset of hypertension.

What is hypertension? Blood pressure simply means the force at which the heart pumps blood around the body. It is recorded with two numbers: the systolic pressure (top number) is the force at which the heart pumps blood around the body, and the diastolic pressure (bottom number) is the resistance to the blood flow in the blood vessels. Both numbers are measured in millimetres of mercury (mmHg). As a general guide, blood pressure is considered to be high at 140/90mmHg, with ideal blood pressure usually considered to be between 90/60mmHg and 120/80mmHg.

High blood pressure rarely has noticeable symptoms but, if left untreated, it increases the risk of serious problems, such as heart attacks, strokes and kidney disease.

Potential causes of hypertension
Age: The older we get, the higher the risk of developing hypertension, because our blood vessels don’t stretch as well anymore

Being overweight: The higher your body mass index (BMI), the higher your risk of high blood pressure

Family history of high blood pressure: Having a family member with high blood pressure means you are more likely to have the condition as well

Increased salt intake: Research has shown that people from African Caribbean backgrounds are more likely to have elevated blood pressure levels due to increased salt intake

Low level of exercise/physical activity

Too much alcohol or caffeinated drinks

Long-term sleep deprivation

Ways to help lower blood pressure 
You can help to reduce your risk of high blood pressure by making certain lifestyle changes. Of course, being African Caribbean is already a big risk factor that we cannot change, but we can invest efforts to modify our lifestyles, by making healthier food choices and increasing our activity level. Some of these changes include:

Maintaining a healthy weight: There is a strong link between high blood pressure and being overweight, so losing weight – even as little as 5-10% of your starting weight – will help. The best way to lose weight is by reducing your calorie intake and increasing your daily physical activity. Speak to your GP about a referral to your community Dietetic service or local weight loss management programme for help with losing weight.

Being physically active: This is one of the most important things you can do to reduce your blood pressure. Try to build more physical activity into your daily routine, aiming for at least 150 minutes (2 ½ hours) of moderate intensity activity per week, starting off slow and steady. ‘Moderate intensity’ activity means any activity that makes you breathe harder and makes your heart beat faster than usual. Remember to check with your GP if starting any new exercise regime to make sure it’s safe to do so, especially if you have any heart-related problems.

‘There is a strong link between high blood pressure and being overweight, so losing weight – even as little as 5-10% of your 
starting weight – will help.’

Reduce salt intake: Keep within the recommended intake of 6g a day (about 1 teaspoon). There is  no need to use salt in cooking if you are already using seasonings, stock cubes and powders, like Maggi/Knorr/All-purpose seasoning and Everyday seasoning. 

Avoid adding salt at the table too. Try using herbs, spices and peppers in cooking instead. 

Limit intake of foods very high in salt, ie. salt fish and smoked turkey (soak in water and drain off salted water before cooking), as well as cheese, crisps and salted nuts.

Reduce alcohol intake: Drinking more than the recommended amount of alcohol can cause high blood pressure and damage to your heart muscle. The recommended limit is 14 units per week for both men and women, and it’s best to spread your intake evenly across the week.

Reducing your intake of coffee and other caffeinated drinks, such as tea and cola drinks; increasing your intake of fruits and vegetables to at least five portions a day; increasing your intake of wholegrain foods, such as wholewheat pasta, wholegrain or multigrain bread, brown rice, and having 2-3 servings of low fat dairy products in your diet will help lower your risk of hypertension.

Treatment
Hypertension is usually treated with a combination of lifestyle changes (as above) and with medication. It is important to have your blood pressure monitored regularly; ideally, an annual check is recommended, if you have an increased risk. If you are already being treated for hypertension, please do take your medication as prescribed, and arrange regular check-ups with your GP. Sometimes people from Black African Caribbean backgrounds omit medication in favour of using local herbal remedies ‘from home’. This practice can be dangerous, as the dose of active ingredients taken is often unknown. Others often wish to employ faith for healing from hypertension, and stop taking their medication. It is important that you make wise decisions about your health. 

In all cases, inform your GP or healthcare provider.

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