Dairy Intake, Reduced Body Iron Stores, and the Development of Type 2 Diabetes Mellitus

Abstract

cited by Rehman et al 1 also found poorer hypertension control rates among African American men, yet no difference in BP control was noted between African American and white women. In their study, Rehman et al 1 looked just at the male hypertensive population and offered no explanation for this sex-related difference among African Americans. Qualitative differences in pharmacotherapy and their possible impact on ethnic BP control rates at Veterans Affairs (VA) and non-VA health care sites were also not specifically discussed.It is known that there are some ethnic differences in the causes of arterial hypertension, with African Americans presenting more often with a salt-sensitive form characterized by low renin levels 3 and abnormal hemodynamic reactivity manifested by increased vascular resistance to physical and mental stress. The proposed underlying pathophysiologic condition is sympathetic overactivity, along with an imbalance among endotheliumderived vasoactive mediators, including the potent vasoconstrictor peptide endothelin-1 and the vasodilator nitric oxide.In a study by Evans et al, 4 young normotensive African American men were found to have significantly higher circulating endothelin-1 levels compared with white men as well as with African American women. In fact, no difference was found in endothelin-1 levels between African American and white women.In another recent study, African American men showed 20% to 40% higher sympathetic discharge rates compared with women. 5 These sex-related differences in the African American population suggest that a specific pathophysiologic condition, possibly meriting a different pharmacologic approach, might be the main cause for poor BP control rates among African American men compared with other groups of hypertensive patients including African American women.