Those Americans seeking to reduce their risk of heart disease are poorly served by such unhelpful Guidelines. Hypertension and Stroke Hypertension is common in the U.S. population as a whole, but affects African Americans disproportionately. The age-adjusted prevalence rates in African Americans, Mexican Americans, and whites were 34 percent, 23.2 percent, and 25.4 percent, respectively, for men, and 31.0 percent, 21.6 percent, and 21.0 percent, respectively, for women. 30 Stroke also occurs disproportionately among African Americans. For women, the corresponding figures were 1.20 and 0.98 percent, respectively.
Dietary factors play a key role in hypertension.
While the importance of limiting salt use is well known, reducing the use of fatty foods and meats below those levels recommended in the current Dietary Guidelines is also clearly beneficial. For example, a study of Seventh-day Adventists showed that among whites, blood pressure medications were used by 22 percent of omnivores, compared to only 7 percent of vegetarians. Among African Americans, blood pressure medications were used by 44 percent of omnivores and only 18 percent of vegetarians. The use of vegetarian diets in controlled trials leads to significant blood pressure reductions in 30 to 75 percent of hypertensive subjects. While Americans vary in their willingness to modify their diets, the current nutrition policies provide no encouragement at all for those who are willing to make more than minimal changes.