Yasmin Williams - HEALTH-WISE Reader's feedback:
Reader Randal wrote: 'I am interested in learning how the data presented in your column were collected. I work in the Pharma/health industry here in NYC in predominantly black populations. The prevalence of hypertension and diabetes is much higher compared to that which you presented even among Caribbean residents which makes the data you presented seem extraordinarily low. My friend is visiting and had BP of 190/90 and his doctor amazingly says it is normal. Which begs the question what is the classification for hypertension in Jamaica? Here the JNC7 guidelines says 125/80 is normal.
What is normal in Jamaica for hypertensive/diabetics?
Response
Dear Randal,
The data come from the Ministry of Health, Jamaica. I am sure that if you write the Director of Health Promotion and Disease Prevention she would be delighted to share further about this collaborative study between the Ministry and the University of the West Indies.
The most current guidelines for managing hypertensives are being promoted and used in Jamaica. We are cognizant of the fact that these recent guidelines require much more effort by patient and doctor to achieve the less than 120/80 recommended.
I cannot imagine a medical doctor telling anybody with a blood pressure of 190/90 that he or she has a normal blood pressure. The Medical Association of Jamaica, many of the specialty organisations like the General Practitioner's Association, The Caribbean College of Physicians and the Association of Consultant Physicians as well as relevant pharmaceutical companies target local practitioners for training in this area. In fact, earlier in the year I did an article in the Wednesday column highlighting the most recent guidelines for managing hypertension.
You must remember that although there is a genetic component in the development of hypertension and diabetes, there is also a lifestyle component which would account for the difference in prevalence of hypertension/diabetes across the black diaspora or in persons of African ancestry in different parts of the world. Professor Rainford Wilks at the Tropical Medical Research Institute, University of the West Indies, Mona has collaborated with colleagues in Africa and the United States to look at this issue.
Best Regards.
Dr. Yasmin Williams is a Family Doctor and Public Health Specialist; e-mail: yourhealth@gleanerjm.com.
