Articulating silences: Experiential and biomedical constructions of hypertension symptomatology

Nancy E. Schoenberg, Elaine M. Drew

Research output: Contribution to journalArticlepeer-review

32 Scopus citations


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 "silentnature 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 "realitythat is yet unresolved.

Original languageEnglish
Pages (from-to)458-475
Number of pages18
JournalMedical Anthropology Quarterly
Issue number4
StatePublished - Dec 2002


  • African Americans
  • Hypertension
  • Knowledge
  • Symptomatology
  • Treatment decision-making

ASJC Scopus subject areas

  • Anthropology


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