Articulating silences: experiential and biomedical constructions of hypertension symptomatology.

In this article, we explore the flexible configuration of a local knowledge system about hypertension symptoms, foregrounding it against prevailing biomedical assertions regarding the asymptomatic or "silent" nature of hypertension. The complex and coherent knowledge system held by older African Americans living in a southern, rural community stands in contrast to the current scientific discourse and local biomedical perspectives on hypertension symptomatology. The older African American participants in this study apply local knowledge of hypertension symptomatology to make health decisions nearly every day. Despite this, most biomedical practitioners maintain a distance from these lay sources of knowledge, often remaining stalwart in their refusal to recognize the existence or influence of symptoms. We conclude that authoritative knowledge ultimately lies in the minds and bodies of the elders, who have encountered symptoms as guideposts that direct action, rather than with a biomedical "reality" that is yet unresolved.

[1]  N. Arar,et al.  An analytical framework for contrasting patient and provider views of the process of chronic disease management. , 2001, Medical anthropology quarterly.

[2]  Suzanne K. Ketler,et al.  Preparing for motherhood: authoritative knowledge and the undercurrents of shared experience in two childbirth education courses in Cagliari, Italy. , 2000, Medical anthropology quarterly.

[3]  W. Dressler,et al.  The Health Consequences of Cultural Consonance: Cultural Dimensions of Lifestyle, Social Support, and Arterial Blood Pressure in an African American Community , 2000 .

[4]  M. Sorrentino.  Turning up the heat on hypertension. It's time to be more aggressive in finding and treating this silent killer. , 1999, Postgraduate medicine.

[5]  C. Mattingly,et al.  Diverse rationalities and multiple realities in illness and healing. , 1998, Medical anthropology quarterly.

[6]  Manfred S. Green,et al.  Hypertension and Sickness Absence: The Role of Perceived Symptoms , 1997, Journal of Behavioral Medicine.

[7]  N. Schoenberg.  A Convergence of Health Beliefs: An "Ethnography of Adherence" of African-American Rural Elders with Hypertension , 1997 .

[8]  I. McDonald,et al.  Cardiac disease construction on the borderland. , 1997, Social science & medicine.

[9]  J Popay,et al.  Public health research and lay knowledge. , 1996, Social science & medicine.

[10]  P. Yablo,et al.  Socio-cultural and behavioural aspects of mosquito-borne lymphatic filariasis in Thailand: a qualitative analysis. , 1995, Social science & medicine.

[11]  P Whelton,et al.  Prevalence of hypertension in the US adult population. Results from the Third National Health and Nutrition Examination Survey, 1988-1991. , 1995, Hypertension.

[12]  W. Dressler.  Health in the African American Community: Accounting for Health Inequalities , 1993 .

[13]  P. Bracken,et al.  Post-empiricism and psychiatry: meaning and methodology in cross-cultural research. , 1993, Social science & medicine.

[14]  S. Heurtin‐Roberts,et al.  The relation of culturally influenced lay models of hypertension to compliance with treatment. , 1992, American journal of hypertension.

[15]  E. Bailey.  Hypertension: An Analysis of Detroit African American Health Care Treatment Patterns , 1991 .

[16]  B. Jordan,et al.  Compliance and the patient's perspective: Controlling symptoms in everyday life , 1989, Culture, medicine and psychiatry.

[17]  E. Bailey.  An ethnomedical analysis of hypertension among Detroit Afro-Americans. , 1988, Journal of the National Medical Association.

[18]  Snow Lf.  A medical anthropologist voices a note of caution: "high blood" is not high blood pressure. , 1976 .

[19]  L. F. Snow.  Folk medical beliefs and their implications for care of patients. A review bases on studies among black Americans. , 1974, Annals of internal medicine.