Hypertension as a Disease of Modern Society

Abstract

About 50 per cent of people in modern societies have blood pressure sufficiently elevated to result in increased mortality. This proportion is much smaller in undisrupted societies of hunter-gatherers. In most cases the elevated blood pressure in modern societies is associated with physiological changes characteristic of chronic stress. The difference between blood pressure in modern populations and that in undisrupted hunter-gatherer societies cannot be accounted for by genetic differences or differences in salt consumption. Two primary features of modern society which contribute to the elevation of blood pressure are community disruption and increased work pressure. Drug therapy and relaxation therapies for hypertension attempt to counteract the physiological effects of social stress. However, it is more appropriate to use the occurrence of hypertension as an indicator of fundamental social problems which need to be solved.

Social Causes of Coronary Heart Disease

“…First, we show that population blood pressure rises with modernization in the same way as excess mortality and in direct relationship to major social sources of stress (2,24). The available blood pressure samples span a much wider range of social types, from hunter-gatherer through modern man, than the death rates, which span only the range from premodern civilized peasantry to modern society.…”

“…Various measures of social stress for each culture predict a large part of the variation of population blood pressure in a statistical model of the 85 samples (2,24). Obesity and salt consumption measures for the same samples generally Social Causes o f Coronary Heart Disease 81 also rise with development and predict some part of the blood pressure trend increase.…”

Birth of the Allostatic Model: From Cannon’s Biocracy to Critical Physiology

“…As a matter of fact, in the 1970s, Sterling and Eyer published a series of articles compiling and commenting on several studies concerning the pathogenic effects of industrialized societies (Eyer, 1975;Eyer, 1977;Sterling & Eyer, 1981). The case of hypertension played a paradigmatic role in the elaboration of this comparative physiology.…”

Preface

“…Hypertension is, indeed, one of the classic 'diseases of civilization', with large differences being seen between countries at different levels of economic development in both prevalence of hypertension and the degree to which blood pressure levels increase with age 6 . Singular hypotheses such as those focusing on sodium intake, or general (indeed inchoate) notions of 'stress' have not proved adequate, but Dressler develops a more nuanced view of cultual congruity and the manner through which this influences behavioural and psychological dispositions that could affect blood pressure.…”