Introduction
Strokes are the leading cause of death in the United States each year; nearly 800,000 strokes occur each year (CDC, 2013). Blood pressure has been identified by a large number of studies as the single most important variable in the prevention and treatment of strokes. It is estimated that one-fourth of all strokes could be avoided if hypertension were better controlled (Woo, 2004). Strokes occur in black middle-aged males at a significantly higher rate than that of other race or gender. The failure to control hypertension only increases the possibility of stroke occurrence. African-Americans have also been identified at an increased risk for having undiagnosed and untreated hypertension. Although this is not completely understood it remains a priority for many providers. The JNC7 (2003), guideline recommends maintaining a systolic blood pressure (SBP) below 120mmHg and a diastolic blood pressure (DBP) below 80 mmHg. Guidelines for starting anti-hypertensive medications begin at 140 and 90 respectively.
After working in the Emergency Department two things concerning black males were recognized; 1) black males are unaware of their hypertensive condition, and 2) strokes can be devastating. It has been apparent that the end result for middle-aged African-American males with untreated hypertension consisted of a number of complications including stroke. Strokes often result in death or permanent disability. As primary care providers the challenge of identifying and effectively treating conditional risk factors in an effort to prevent stroke is obvious. Intervention and treatment could result in an unknown number of preventable strokes, death and permanent disability.
The facts of stroke and risk factors for this devastating disease are apparent; however the specific limitations for blood pressure risk in middle-aged African-American males have not been so obvious. Does moderately increased blood pressure in African-American males place them at the...