Case For
There is a clear body of scientific evidence supporting the idea that members of certain ethnicities do tend to develop high blood pressure more often than people from other ethnic backgrounds. This same body of data also identifies several congruent populations, i.e., ethnic groups that develop high blood pressure at comparable rates.
In nearly all of the studies on ethnicity as a risk factor for high blood pressure, two groups emerge as having risk that is much different than that for the population on average
African-Americans, for example, consistently lead incidence profiles in high blood pressure studies, with about 36% of the population developing high blood pressure at some point. This is compared to about 20% in the Caucasian, Native American, and Hispanic populations. African American populations also tend to develop kidney problems at a higher rate than their Caucasian counterparts, and tend to have poorer outcomes overall.
On the other side of the equation, Asian populations, especially Asian Pacific Islanders (Hawaii, Japan, etc) consistently have the lowest demonstrated risk of developing high blood pressure, with an average lifetime risk of about 9.5% in men and 8.5% in women.
Significantly, these numbers hold relatively constant across many independent studies, suggesting that some genetic components may be at work, and that the elevated, or decreased, risk profiles genuinely are a factor of ethnic background.
The case, however, may be more complicated.
Case Against
Recently, a group of researchers has attempted to more closely examine the increased high blood pressure risk exhibited by African-American populations. To do so, they compared certain biological factors known to influence blood pressure in populations of African-Americans and native populations from the African continent. In doing so, they attempted to find a clear genetic rationale for the higher incidence of high blood pressure among African-Americans.
Their results, however, were very different than expected. They did find genetic similarities, which could possibly explain the increased incidence of high blood pressure in African-Americans, but they further discovered that the same genetic variant actually caused protection from high blood pressure in the native populations, a very curious and confusing result.
Similarly, studies have been done on various Asian populations and have found that the decreased overall incidence of high blood pressure tends to moderate when these people are placed into different cultural circumstances. For example, when native Vietnamese populations migrate to the United States, their risk of developing high blood pressure tends to approach that of Caucasians within a short time.
These results raise the question that it might be other, societal forces that contribute to differing rates of high blood pressure among various ethnic groups in the developed world. For example, minorities who occupy a lower place on the socioeconomic ladder and have poorer health care and less healthy lifestyles develop high blood pressure at increased rates. Data is still somewhat lacking on what happens to these ethnic groups at higher socioeconomic rungs.
Where it Stands
It is clear that certain ethnic groups are at increased risk for developing high blood pressure. It is not clear, however, whether this increased risk is a function of real genetic influences, or whether some social aspects and socioeconomic factors contribute more strongly than genetics.
What is clear, though, is that with respect to a particular patient, ethnicity cannot be changed. Therefore, regardless of the underlying reasons for these differences, the fact remains that healthy lifestyle choices, consistent monitoring, and careful adherence to treatment, if needed, are all important to remaining healthy.
