Abstract
In large part because of increased risk of hypertension observed among blacks compared with whites, considerable attention has been focused on possible racial differences in ion metabolism. There are at least two reasons that these differences might be important. First, etiologic research in most disciplines relies heavily on the investigation of high-risk subgroups. If we knew why the risk of hypertension among blacks is twice that found among whites we would know a great deal more about what causes this disease than we do today. Second, cardiovascular diseases continue to be the primary cause of higher death rates experienced by black adult Americans. Approximately half of the higher mortality among blacks compared with whites can be accounted for by the complications of high blood pressure (77). We urgently need effective strategies for primary prevention of this disease; to achieve that goal a better understanding of the etiologic process is required. Whether the excess risk of hypertension among U.S. blacks is conferred by their genetic heritage or exposure to high levels of environmental risk factors remains undetermined Observed phenotypic alternations in ion metabolism could result from either genetic predisposition or exposures to external causes. A distinction between a finding that reflects special or unique characteristics of the black population, or a universal human trait that is simply exaggerated in this group, is crucial when the data collected on ion metabolism are being used to construct a theory of the pathophysiology of hypertension. Is the pathophysiology of hypertension essentially the same in blacks and whites, or can we expect to find consistent differences at a basic level? There is evidence, for example, that among the various hypertensive strains of rats, different alterations in ion transport systems exist (28,35). Are there comparable differences among “strains” of humans? Before reviewing the primary reports in this field we will attempt to address the implications of these questions.
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Cooper, R.S., Borke, J.L. (1993). Intracellular Ions and Hypertension in Blacks. In: Fray, J.C.S., Douglas, J.G. (eds) Pathophysiology of Hypertension in Blacks. Clinical Physiology Series. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7577-4_9
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