Western biomedicine defines “hypertension” as an elevation in the blood pressure which can lead to heart disease, stroke and other catastrophic illnesses. However, one folk model exemplifies how differences in understanding of the meaning of words can influence health care.

In some African American communities, “High Pertension” or “tension” is thought to be a condition based on emotions that come and go. The blood is thought to rise and fall, making the person susceptible to “falling out” or fainting episodes. The condition cannot be treated or cured. Those with “tension” try to avoid situations involving emotional ordeals. “High blood”, on the other hand, is considered to be a persistent condition in which the blood is too thick, or too rich. It is thought that the blood rises up to the head and remains there, making the heart work too hard. Identified symptoms include red eyes, nosebleeds, headaches, and tasting blood. It is thought that certain people are susceptible to it, and the condition is made worse by a diet of rich, sweet, or heavy foods. People with “high blood” believe that they have the condition for life, but can control it by avoiding certain foods.

Patient compliance with blood pressure medication may be problematic if the provider does not understand and address the issue of which type of disease the patient believes he or she has.