Posted by Chuk Igwe

In Reply to: The salt theory as proferred by Nowa does not seem to me a satisfactory explanation of the hypertension issue among the black race posted by Egwu Kalu

Professor Kalu:
As engineers we are used to near perfect explanation of phenomena. In
medicine, it does not work that way, explanations are merely partial
'reasonabilification' of phenomena being discussed.
Now as an engineer, my explanation of hypertension or high blood pressure is
from the systemic point of view. Pressure as we know it is Force divided by
the relevant surface area of incidence. In the body as a system, we are
looking for things that affect the fluid force, or what changes the surface
area of the body as a whole if the fluid force is relatively stable within
quiescent points. Thus there are many factors that can affect the blood
pressure of this human system.
Now at optimum functioning capacity, quiescent systolic blood pressure is
at youth supposed to be 100 + age (Hg, mm) . However as one gets older that
number is fraught with jeopardy since it is creeping to the regions of
danger. The factors that affect this quiescent operating point is the
inability of the body to be elastic enough to expand or contract in sympathy
with other body mechanisms like the potasium/sodium pump activity. So one of
the ways to see it is that sodium is upsetting the equilibrium with potassium
in the osmotic relationship that exists between human cells and body fluid.
As the theory goes, black people have this inability to fully control the
potassium/ sodium activity. Hence one way of treating blood pressure mostly
in black people is to reduce this osmotic pressure by reducing the salt (
Na+) in the whole body fluid system.
Secondly because of old age and or because of activities of some
fear/anxiety related mechanisms, the heart may need to increase its
activities to supply blood to various sub systems of the body. Hence another
way of reducing blood pressure is by reducing the pumping activities of the
heart. Thirdly the other way of treating blood pressure is to manipulate
blood vessels to dilate and thus increase the surface area of the body system
in question. Hence any activity that manipulates the vessels to dilate
decreases the body pressure while other conditions are relatively the same.
It is obvious that the three phenomena can coalesce and help send the
body system pressure higher than is actually good for health. That is why
there are disparities between the Caribbean and the black American. That is
also why there are hundreds of drugs that can act on any of the incident
physiological mechanisms and hence directly or indirectly reduce blood
pressure. Potentially therefore, there are thousands of combinations that can
coalesce and increase the quiescent operating blood pressure of any human
being.
Thus the salt theory is just one of the areas that have shown up as a
dominant mechanism for the increase of blood pressure among black peoples.
Now there seems to me that anxiety and other hate related phenomena can also
manipulate the body sub system to increase blood pressure too.
What we really need is statistics to butters the theories being
propagated as causative factors for the hypertension epidemic among black
people. It seems to me that the statistics being quoted from Akinkugbe et
al. is very outdated considering the anecdotal evidence of hypertension cases
that filter out of Nigeria. I believe that hypertension cases in Nigeria is
as prevalent as it is in Black America. However we may never know until we
have statistics to butters this assertion.

Sincerely,

Chuk Igwe

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