Cumulative Incidence of Hypertension by 55 Years of Age in Blacks and Whites: The CARDIA Study

Thomas, Stephen J.; Booth, John N.; Dai, Chen; Li, Xuelin; Allen, Norrina B.; Calhoun, David A.; Carson, April P.; Gidding, Samuel S.; Lewis, Cora E.; Shikany, James M.; Shimbo, Daichi; Sidney, Stephen; Muntner, Paul

doi:10.1161/jaha.117.007988

Cited by 90 publications

(65 citation statements)

References 40 publications

(49 reference statements)

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“…Among young adults in the CARDIA (Coronary Artery Risk Development in Young Adults) Study who had baseline BP <130/<80 mm Hg at ages 18 to 30 years, by age 55 years, ≈75% of black men and women were hypertensive in contrast to 54% of white men and 40% of white women (Figure). 3 For the subset of black men and women who had baseline BP in the high normal range of 120 to 129/75 to 79 mm Hg at age 18 to 30 years, ≈60% were hypertensive by age 35 years and ≈87% were hypertensive by age 55 years. Moreover, black men and women with baseline BP in the 110 to 119/70 to 74 mm Hg range developed hypertension over time at a rate similar to white men and women with baseline BP 120 to 129/75 to 79 mm Hg (ie, a difference of ≈10/5 mm Hg, with ≈60% of both racial groups hypertensive by age 47 years).…”

Section: High Absolute Risk Of Hypertension In Blacks With Normal Andmentioning

confidence: 99%

“…In fully adjusted models accounting for age, sex, body mass index, systolic BP, diastolic BP, cigarette smoking, parental history of hypertension, highest level of education, physical fitness, serum uric acid, alcohol consumption, and Dietary Approaches to Stop Hypertension eating plan concordance, blacks were ≈1.5 to 2.5 times more likely to develop hypertension than their white counterparts 3. Treating hypertension does not completely abolish excess hypertension‐related risk 5.…”

Section: High Absolute Risk Of Hypertension In Blacks With Normal Andmentioning

confidence: 99%

“…This commentary will address 4 points related to the current report by Thomas et al3: High absolute risk of hypertension, defined by systolic blood pressure (BP) ≥130 mm Hg and/or diastolic BP ≥80 mm Hg or treatment for hypertension.Relative and absolute risk of stage 1 hypertension (130–139/85–89 mm Hg) for clinical cardiovascular disease (CVD) in blacks.Benefits of lifestyle intervention for prevention of hypertension and CVD.Rationale for pharmacotherapy of stage 1 hypertension in blacks. …”

Section: Introductionmentioning

confidence: 98%

“…The racial disparities are greatest in younger adults and decline with advancing age 2. The article in this issue of the Journal of the American Heart Association (JAHA) by Thomas et al,3 “Cumulative Incidence of Hypertension by 55 Years of Age in Blacks and Whites: the CARDIA Study,” highlights large racial disparities in incident hypertension between young black and white adults and has important implications for reducing disparities in prevalent hypertension and cardiovascular and renal complications in younger black adults.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Defining Hypertension by Blood Pressure 130/80 mm Hg Leads to an Impressive Burden of Hypertension in Young and Middle‐Aged Black Adults: Follow‐Up in the CARDIA Study

Egan

2018

JAHA

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Section: High Absolute Risk Of Hypertension In Blacks With Normal Andmentioning

confidence: 99%

Section: High Absolute Risk Of Hypertension In Blacks With Normal Andmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Defining Hypertension by Blood Pressure 130/80 mm Hg Leads to an Impressive Burden of Hypertension in Young and Middle‐Aged Black Adults: Follow‐Up in the CARDIA Study

Egan

2018

JAHA

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“…It also may actually be a snapshot of the HTN trend in the general population. Indeed, blacks are known to be at greater risk for elevated blood pressure with earlier onset than Caucasians [48,49]. A specific reason to our population may be the high prevalence of HTN and uncontrolled HTN in Kinshasa [50].…”

Section: Discussionmentioning

confidence: 96%

Polypoidal Choroidal Vasculopathy in Congolese Patients

Kabedi

Kayembe

Elongo

et al. 2020

Journal of Ophthalmology

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Purpose. Polypoidal choroidal vasculopathy (PCV) is a visually debilitating disease that mostly affects people of African and Asian heritage. Indocyanine green angiography (ICGA) is the recommended exploratory method for definitive diagnosis. The disease has been extensively described in Asians and Caucasians, but not in Africans. This study was conducted to document the clinical presentation and optical coherence tomography features of polypoidal choroidal vasculopathy (PCV) in Congolese patients. Methods. A prospective case series of patients with PCV was performed between January 2017 and June 2019. Routine ocular examination was performed including best corrected visual acuity measurement, slit-lamp examination, dilated direct fundoscopy, and spectral domain optical coherence tomography (OCT). The diagnosis was based on a combination of clinical and OCT signs. Results. Fourteen patients were diagnosed with PCV during this period. The average age was 64.7 ± 6.9 years. There were 8 females. Ten (71.4%) patients had systemic hypertension. Most patients (n = 9, 64.3%) had bilateral involvement. Blurred vision was the most common complaint (71.4%). The main clinical presentation was subretinal exudates, seen in 19 (82.6%) eyes of 11 (78.6%) patients and subretinal hemorrhage in 10 (43.5%) eyes. Macular localization was found in 16 eyes (69.5%) of 12 (85.7%) patients. Drusen were observed in 35.7% of the patients. On OCT imaging, thumb-like pigment epithelial detachment and subretinal exudation were the most frequent features, observed in 92.9% and 71.4% of the patients, respectively. Conclusions. PCV in Congolese patients showed features that are more similar to those observed in Caucasians. In this setting where indocyanine green angiography is not available, OCT facilitates the diagnosis of PCV.

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Lifetime Risks for Hypertension by Contemporary Guidelines in African American and White Men and Women

et al. 2019

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Patterns of hypertension risk development over the adult lifespan and lifetime risks for hypertension under the American Heart Association and American College of Cardiology (AHA/ACC) 2017 thresholds for hypertension (Ն130/80 mm Hg) are unknown. OBJECTIVE To quantify and compare lifetime risks for hypertension in white and African American men and women under the AHA/ACC 2017 and the Seventh Joint National Commission (JNC7) hypertension thresholds. DESIGN, SETTING, AND PARTICIPANTS We used individual-level pooled data from 3 contemporary cohorts in the Cardiovascular Lifetime Risk Pooling Project: the Framingham Offspring Study, the Coronary Artery Risk Development in Young Adults study, and Atherosclerosis Risk in Communities study. These community-based cohorts included white and African American men and women with blood pressure assessment at multiple cohort examinations. MAIN OUTCOMES AND MEASURES Cumulative lifetime risk for hypertension from ages 20 through 85 years, adjusted for competing risk of death and baseline hypertension prevalence. Incident hypertension under the AHA/ACC threshold was defined by a single-occasion blood pressure measurement of 130/80 mm Hg or more or self-reported use of antihypertensive medications. Incident hypertension under the JNC7 threshold was defined by a single-occasion blood pressure measurement of 140/90 mm Hg or more or the use of antihypertensive medications. RESULTS A total of 13 160 participants contributed 227 600 person-years of follow-up; the data set included individual-level data on 6313 participants at baseline (median age, 25 years), plus person-year data from participants in the Atherosclerosis Risk in Communities and Framingham Offspring studies who enrolled at older ages. Baseline prevalence of hypertension under the AHA/ACC 2017 threshold in participants entering the data set between 20 and 30 years of age was 30.7% in white men (n = 549 of 1790), 23.1% in African American men (n = 245 of 1063), 10.2% in white women (n = 210 of 2070), and 12.3% in African American women (n = 171 of 1390). White men had lifetime risk of hypertension of 83.8% (95% CI, 82.5%-85.0%); African American men, 86.1% (95% CI, 84.1%-88.1%); white women, 69.3% (95% CI, 67.8%-70.7%); and African American women, 85.7% (95% CI, 84.0%-87.5%). These were greater than corresponding lifetime risks under the JNC7 threshold for hypertension (white men, 60.5% [95% CI, 58.9%-62.1%]; African American men, 74.7% [95% CI, 71.9%-77.5%]; white women, 53.9% [95% CI, 52.5%-55.4%]; and African American women, 77.3% [95% CI, 75.0%-79.5%]). CONCLUSIONS AND RELEVANCE Under the AHA/ACC 2017 blood pressure threshold for hypertension, lifetime risks for hypertension exceeded 75% for African American men and women and white men. Furthermore, prevalence of blood pressure of 130/80 mm Hg or more is very high in young adulthood, suggesting that efforts to prevent development of hypertension should be focused early in the life course.

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Cumulative Incidence of Hypertension by 55 Years of Age in Blacks and Whites: The CARDIA Study

Cited by 90 publications

References 40 publications

Defining Hypertension by Blood Pressure 130/80 mm Hg Leads to an Impressive Burden of Hypertension in Young and Middle‐Aged Black Adults: Follow‐Up in the CARDIA Study

Defining Hypertension by Blood Pressure 130/80 mm Hg Leads to an Impressive Burden of Hypertension in Young and Middle‐Aged Black Adults: Follow‐Up in the CARDIA Study

Polypoidal Choroidal Vasculopathy in Congolese Patients

Lifetime Risks for Hypertension by Contemporary Guidelines in African American and White Men and Women

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