Ethnic Variability Among Jews is Associated With Hypertension: Results of a Nationwide Study of 1.44 Million Adolescents

Abstract

BACKGROUND Adolescent hypertension is a major cardiovascular risk factor that may be related to ethnic variability. Contemporary Jews can be divided into three distinct ethnic groups: Ashkenazi, Oriental, and Sephardi origins. The aim of our study was to investigate the association of ethnicity and hypertension among Israeli adolescents. METHODS We conducted a population retrospective cohort study of males and females, aged 16–19, eligible for mandatory military service in the Israeli Defense Forces (IDF) between 1994 and 2013. Medical and sociodemographic data, including body mass index (BMI), age, years of education, residential socioeconomic status, and parents’ country of birth, were retrieved. Ethnicity of the parents was based upon their country of birth. The examinees were assigned to a certain ethnicity only if both parents had the same ethnicity. Logistic regression models were applied to compute the odds ratio (OR) and 95% confidence intervals (95% CI) for hypertension among the different Jewish ethnicities. RESULTS The final cohort included 1,445,176 adolescents, of whom 716,289 were born to parents of the same Jewish ethnicity. Ashkenazi ethnicity was associated with an increased risk of hypertension compared to Sephardi and Oriental ethnicities (adjusted OR of 2.93 (95% CI, 2.52–3.41) and 1.56 (1.38–1.77), respectively). Oriental ethnicity was associated with an increased risk of hypertension compared with the Sephardi ethnicity (OR of 1.91 (1.60–2.27)). Similar results were observed in a sub-analysis, which included only Israeli-born examinees. CONCLUSIONS Our results indicate that ethnicity is significantly associated with hypertension among Jewish adolescents. Ashkenazi Jews had the highest risk of hypertension.

Adolescent Hypertension Is Associated With Stroke in Young Adulthood: A Nationwide Cohort of 1.9 Million Adolescents

“…Yet, the population in this study is considered to have a heterogenous genetic ancestry. 30,31 In conclusion, hypertension, even in otherwise healthy adolescents, was associated with overall and specifically ischemic stroke in young adulthood. These findings suggest a potential clinical benefit of hypertension screening among adolescents.…”

The opposing trends of body mass index and blood pressure during 1977–2020; nationwide registry of 2.8 million male and female adolescents

“…This mostly comprised Ashkenazi Jews immigrating from the countries of the former Union of Soviet Socialist Republics. Moreover, immigration status [ 26 ] and Ashkenazi ethnicity [ 37 ] in particular, were associated with increased risk for adolescent elevated BP. This explanation is less probable since we analyzed separately Israeli-born adolescents and observed similar trends to that of the entire study population.…”