title: Articulating silences: experiential and biomedical constructions of hypertension symptomatology.
abstract: 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.
authors.affiliation: Departments of Behavioral Science, Anthropology, and Internal Medicine, (Cardiology) and Sanders-Brown Center on Aging, University of Kentucky, USA. nesch@uky.edu
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Schoenberg
authors.forename: Elaine M
authors.initials: EM
authors.lastname: Drew
mesh_terms: D001741:Black or African American / Q000193:education / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health / Q000208:ethnology*; D002908:Chronic Disease / Q000453:epidemiology; D004522:Educational Status; D005260:Female; D005431:Florida; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006973:Hypertension / Q000208:ethnology* / Q000503:physiopathology / Q000523:psychology; D008297:Male; D011203:Poverty / Q000208:ethnology; D036301:Qualitative Research; D012424:Rural Population; D011795:Surveys and Questionnaires