Symposium ArticleRacial Differences in Hypertension: Implications for High Blood Pressure Management
Section snippets
BLOOD PRESSURE AND HYPERTENSION LEVELS
Nearly one third of the adult population in the united States is considered to have hypertension with elevated blood pressure (≥ 140/90 mm Hg) and/or being treated with antihypertensive medication. The prevalence of hypertension is higher in both middle-aged and older African Americans compared with non-Hispanic whites.10., 11. As presented in Figure 1, data from the National Health and Nutrition Examination Survey (NHANES) show the racial disparities with black men and women having
HYPERTENSION TREATMENT AND CONTROL
Although large-scale clinical trials have consistently demonstrated that the control of elevated blood pressure significantly reduces the risk of major cardiovascular disease, stroke and end-stage renal disease outcomes, a substantial portion of patients with hypertension do not achieve blood pressure control.15 Data from the National Health and Examination Survey suggest that blood pressure is controlled for less than two thirds of all patients on antihypertensive medications.12., 18. African
HYPERTENSION RISKS
The higher hypertension prevalence at earlier ages and more severe blood pressure levels correlate with the higher disease risks for blacks compared with whites. The risk ratios for stage 1 hypertension (≤ 140/90 mm Hg) and stage 2 hypertension (≥ 160/95 mm Hg) are presented in Table 1 for the 4 race-sex groups and 30-year all-cause morality.3 The risk ratios are significant for all but are greater for black men and women. Likewise, the risk ratios are higher in the more severe blood pressure
FACTORS ASSOCIATED WITH RACIAL DISPARITIES
Although the disparities in blood pressure levels, hypertension prevalence and control and high blood pressure risks are evident, the factors associated with the race differences are less evident. However, several parameters are proposed that may contribute to the disparities.32
CONCLUSIONS AND IMPLICATIONS
The racial disparities in hypertension and hypertension risks have significant implications for high blood pressure prevention, management and control programs and strategies, as well as gaps in research. Decades of hypertension control efforts have been attributed in part to the decline in stroke mortality identified for the past decades.43 Although clinical guidelines and prevention strategies recognize the racial disparities in risks from hypertension,44., 45. evidence from clinical trials
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The author has no financial or other conflicts of interest to disclose.