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Racial and ethnic differences in hypertension

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Abstract

Hypertension is a major cause of disease burden in all racial and ethnic groups and in both developing and developed regions and countries. Much of the racial and ethnic disparity in cardiovascular outcomes can be attributed to the excess burden of hypertension. Racial and ethnic differences in blood pressure occur because of biology and sociology. Causes of racial differences in blood pressure likely begin early in life and reflect the complex relationship of these gene and environment interactions. Hypertension treatment and control remain less than optimal worldwide, and awareness is still a problem in many racial and ethnic groups. Instituting lifestyle changes for the primary prevention and treatment of hypertension among the general population would decrease prevalence and be effective in eliminating many racial and ethnic differences. This review highlights racial and ethnic differences in the prevalence and incidence of hypertension and identifies contributing factors associated with these differences.

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References and Recommended Reading

  1. Ezzati M, Lopez AD, Rodgers A, et al.: Selected major risk factors and global and regional burden of disease. Lancet 2002, 360:1347–1360.

    Article  PubMed  Google Scholar 

  2. Jones DW, Hall JE: Racial and ethnic differences in blood pressure, biology and sociology. Circulation 2006, 114:2757–2759.

    Article  PubMed  Google Scholar 

  3. National Center for Health Statistics: National Health and Nutrition Examination Survey. Available at: http://www. cdc.gov/nchs/nhanes.htm. Accessed September 1, 2007.

  4. Chobanian AV, Bakris GB, Black HR, et al.: The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. The JNC 7. JAMA 2003, 289:2560–2572.

    Article  PubMed  CAS  Google Scholar 

  5. American Heart Association: Heart disease and stroke statistics — 2007 update. Dallas, TX: American Heart Association; 2007.

    Google Scholar 

  6. Wong MD, Shapiro MF, Boscardin WJ, Ettner SL: Contribution of major diseases to disparities in mortality. N Engl J Med 2002, 347:1585–1592.

    Article  PubMed  Google Scholar 

  7. Franco OH, Peeters A, Bonneux L, de Laet C: Blood pressure in adulthood and life expectancy with cardiovascular disease in men and women: life course analysis. Hypertension 2005, 46:261–262.

    Article  CAS  Google Scholar 

  8. Yusuf S, Hawken S, Ounpuu S, et al.: Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet 2004, 364:937–952.

    Article  PubMed  Google Scholar 

  9. Kearney PM, Whelton M, Reynolds K, et al.: Global burden of hypertension: analysis of worldwide data. Lancet 2005, 365:217–223.

    PubMed  Google Scholar 

  10. Kearney PM, Whelton M, Reynolds K, et al.: Worldwide prevalence of hypertension: a systematic review. J Hypertens 2004, 22:11–19.

    Article  PubMed  CAS  Google Scholar 

  11. Ogden CL, Carroll MD, Curtin LR, et al.: Prevalence of overweight and obesity in the United States, 1999–2004. JAMA 2006, 295:1549–1555.

    Article  PubMed  CAS  Google Scholar 

  12. Ong KL, Cheung BM, Man YB, et al.: Prevalence, awareness, treatment, and control of hypertension among United States adults 1999–2004. Hypertension 2007, 49:69–75.

    Article  PubMed  CAS  Google Scholar 

  13. Racial/Ethnic Disparities in Prevalence, Treatment, and Control of Hypertension-United States, 1999–2002. MMWR Morb Mortal Wkly Rep 2005, 54:7–9.

  14. Kramer H, Han C, Post W, et al.: Racial/ethnic differences in hypertension and hypertension treatment and control in Multi-Ethnic Study of Atherosclerosis (MESA). Am J Hypertens 2004, 7:963–970.

    Article  Google Scholar 

  15. Douglas JG, Bakris GL, Epstein M, et al.; for the Hypertension in African Americans Working Group of the International Society of Hypertension in Blacks: Management of high blood pressure in African Americans: consensus statement of the Hypertension in African Americans Working Group of the International Society of Hypertension in Blacks. Arch Intern Med 2003, 163:525–541.

    Article  PubMed  Google Scholar 

  16. Kokkinos PF, Narayan P, Colleran JA, et al.: Effects of regular exercise on blood pressure and left ventricular hypertrophy in African American men with severe hypertension. N Engl J Med 1995, 333:1462–1467.

    Article  PubMed  CAS  Google Scholar 

  17. McKetney EC, Ragland DR: John Henryism, education, and blood pressure in young adults. The CARDIA study. Coronary Artery Risk Development in Young Adults study. Am J Epidemiol 1996, 143:787–791.

    PubMed  CAS  Google Scholar 

  18. Appel LJ, Moore TJ, Obarzanek E, et al.; for the DASH Collaborative Research Group: A clinical trial of the effects of dietary patterns on blood pressure. N Engl J Med 1997, 336:1117–1124.

    Article  PubMed  CAS  Google Scholar 

  19. Karanja NM, McCullough ML, Kumanyika SK, et al.: Preenrollment diets of Dietary Approaches to Stop Hypertension trial participants. DASH Collaborative Research Group. J Am Diet Assoc 1999, 99:S28–S34.

    Article  PubMed  CAS  Google Scholar 

  20. Intersalt Cooperative Research Group: Intersalt: an international study of electrolyte excretion and blood pressure: results for 24 hour urinary sodium and potassium excretion. BMJ 1988, 297:319–328.

    Article  Google Scholar 

  21. Veterans Administration Cooperative Study Group on Antihypertensive Agents: Urinary and serum electrolytes in untreated black and white hypertensives. J Chron Dis 1987, 40:839–847.

    Article  Google Scholar 

  22. Weinberger MH: Salt sensitivity of blood pressure in humans. Hypertension 1996, 27:481–490.

    PubMed  CAS  Google Scholar 

  23. He FJ, Markandu ND, Sangella GA, MacGregor GA: Importance of the renin system in determining blood pressure fall with salt restriction in black and white hypertensives. Hypertension 1998, 32:820–824.

    PubMed  CAS  Google Scholar 

  24. Sacks FM, Svetkey LP, Vollmer WM, et al.; for the DASH-sodium Collaborative Research Group: Effects of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. N Engl J Med 2001, 344:3–10.

    Article  PubMed  CAS  Google Scholar 

  25. Feng FJ, MacGregor GA: Importance of salt in determining blood pressure in children; meta-analysis of controlled trials. Hypertension 2006, 48:861–869.

    Article  CAS  Google Scholar 

  26. Andrew ME, Jones DW, Wofford MR, et al.: Ethnicity and unprovoked hypokalemia in the Atherosclerosis Risk in Communities Study. Am J Hypertens 2002, 15:594–599.

    Article  PubMed  CAS  Google Scholar 

  27. Whelton PK, He J, Cutler JA, et al.: Effects of oral potassium on blood pressure. JAMA 1997, 277:1624–1632.

    Article  PubMed  CAS  Google Scholar 

  28. Jones DW, Kim JS, Andrew ME, et al.: Body mass index and blood pressure in Korean men and women: the Korean national blood pressure survey. J Hypertens 1994, 12:1433–1437

    Article  PubMed  CAS  Google Scholar 

  29. Garrison RJ, Kannel WB, Stokes III JS, et al.: Incidence and precursors of hypertension in young adults; the Framingham offspring study. Prev Med 1987, 16:235.

    Article  PubMed  CAS  Google Scholar 

  30. Stevens VJ, Obarzanek E, Cook N, et al.: Longterm weight loss and changes in blood pressure: results of the Trials of Hypertension Prevention, phase II. Ann Inter Med 2001, 134:1–11.

    CAS  Google Scholar 

  31. Wofford MR, Hall JE: Pathophysiology and treatment of obesity hypertension. Curr Pharm Design 2004, 10:3621–3637.

    Article  CAS  Google Scholar 

  32. Calhoun DA, Mujtinga ML, Collins AS, et al.: Normatensive blacks have heightened sympathethic response to cold pressor test. Hypertension 1993, 22:801–805.

    PubMed  CAS  Google Scholar 

  33. Murphy JK, Alpert BS, Walker SS: Consistency of ethnic differences in children’s pressor reactivity: 1987 to 1992. Hypertension 1994, 23:I152–I155.

    PubMed  CAS  Google Scholar 

  34. Wang X, Poole JC, Treiber FA, et al.: Ethnic and gender differences in ambulatory blood pressure trajectories: results from a 15-year longitudinal study in youth and young adults. Circulation 2006, 114:2780–2787.

    Article  PubMed  Google Scholar 

  35. Parker ED, Schmitz KH, Jacobs DR Jr, et al.: Physical activity in young adults and incident hypertension over 15 years of follow-up: the CARDIA study. Am J Public Health 2007, 97:703–709.

    Article  PubMed  Google Scholar 

  36. Profant J, Dimsdale JE: Race and diurnal bood pressure patterns. A review and meta-analysis. Hypertension 1999, 33:1099–1104.

    PubMed  CAS  Google Scholar 

  37. The ALLHAT Officers and coordinators for the ALLHAT collaborative Research Group: Major outcomes in high-risk hypertensive patients randomized to angiotensin converting enzyme inhibitor or calcium channel blocker vs diuretic: the antihypertensive and lipid-lowering treatment to prevent heart attack trial (ALLHAT). JAMA 2002, 288:2981–2997.

    Article  Google Scholar 

  38. Hypertension-related mortality among Hispanic subpopulations-United States, 1995–2002. MMWR Morb Mortal Wkly Rep 2006, 55:177–180.

  39. Whelton PK, He J, Appel LJ, et al.: Primary prevention of hypertension clinical and public health advisory from the National High Blood Pressure Education Program. JAMA 2002, 288:1882–1888.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Medicine, Division of General Internal Medicine/Hypertension, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA

    Deborah S. Minor

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  1. Deborah S. Minor
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  2. Marion R. Wofford
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  3. Daniel W. Jones
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Correspondence to Deborah S. Minor.

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Minor, D.S., Wofford, M.R. & Jones, D.W. Racial and ethnic differences in hypertension. Curr Atheroscler Rep 10, 121–127 (2008). https://doi.org/10.1007/s11883-008-0018-y

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