Racial and Ethnic Differences in Blood Pressure

Jones, Daniel W.; Hall, John E.

doi:10.1161/circulationaha.106.668731

Cited by 50 publications

(35 citation statements)

References 14 publications

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“…African Americans (AA’s) have earlier onset and higher prevalence of essential hypertension (EH) and greater associated end-target organ damage than European Americans (EA’s) 1–3 . This race/ethnicity disparity may be partially explained by varied mechanistic pathways including race/ethnicity differences in chronic stress exposure, stress induced BP reactivity, vasoactive substance release (e.g., epinephrine, endothelin-1, angiotensin II, brain natriuretic peptide, and nitric oxide) and sodium handling 4–11 .…”

Section: Introductionmentioning

confidence: 99%

Race/ethnicity determines the relationships between oxidative stress markers and blood pressure in individuals with high cardiovascular disease risk

et al. 2016

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Oxidative stress (OS) and cardiovascular (CV) reactivity are related to CV morbidity and mortality. However, little is known about the relationships between these CV risk factors and their confounders. We hypothesize that higher OS is linked to higher blood pressure (BP) reactivity to acute laboratory stressors and in the natural setting. We studied 137 subjects with a family history of hypertension and early myocardial infarction. There were 63 European Americans (EA’s) (38 males) and 74 African Americans (AA’s) (35 males), aged 19 to 36(27.6+/−3.1). The protocol included a competitive video game, cold stressor, and ambulatory BP recording. Blood samples were drawn 6 times for OS markers (8-OHdG and 8-Isoprostane) assay. Repeated measures analyses of covariance were used to test for mean differences and Pearson correlations were used to test OS and BP associations. There were no significant race/ethnicity differences in BP reactivity to either stressor (both p’s>0.48). 8-OHdG levels were significantly lower across all time points for AA’s than for EA’s (p<0.05) while levels of 8-isoprostane did not differ significantly (p>.10). Averaged 8-OHdG levels significantly correlated with SBP reactivity (r=0.45, <0.01) and 24-hour, daytime, and nighttime SBP (r range=0.37 to 0.42, all p’s<0.02) for EA’s but not for AA’s, whereas 8-isoprostane levels were significantly correlated with reactive SBP and nighttime DBP (both r’s=0.38, p<0.01) for AA’s but not for EA’s. These findings suggest a link between OS and BP changes in subjects at high risk for CV disease. Further, race/ethnicity determines which OS marker will impact BP variation implying race/ethnicity differences in OS related mechanisms of CVD.

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Section: Introductionmentioning

confidence: 99%

Race/ethnicity determines the relationships between oxidative stress markers and blood pressure in individuals with high cardiovascular disease risk

et al. 2016

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“…Race and ethnicity are difficult to define and classify, and the science is complex. Much of the work in this area is focused in the United States because of our unique racial and ethnic diversity as well as the social and political issues related to this diversity [2]. The National Health and Nutrition Examination Survey (NHANES) [3] is commonly used for monitoring trends in health status.…”

Section: Introductionmentioning

confidence: 99%

Racial and ethnic differences in hypertension

Minor

Wofford²,

Jones³

2008

Curr Atheroscler Rep

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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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“…Despite these limitations, our study provides insight to hypertension care of some of the most vulnerable populations in the United States and assesses racial/ethnic disparities among populations such as non‐Hispanic Asian Americans and non‐Hispanic AIAN where previous studies have focused on non‐Hispanic White and non‐Hispanic African American populations …”

Section: Discussionmentioning

confidence: 99%

Exploring racial/ethnic disparities in hypertension care among patients served by health centers in the United States

Sripipatana

Pourat

Chen

et al. 2019

J of Clinical Hypertension

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Some racial/ethnic minorities are more likely to have hypertension and experience increased hypertension‐related morbidity and mortality compared to whites. Health Resources and Services Administration‐funded health centers care for over 27 million patients, 62 percent of whom are racial/ethnic minorities. We assessed the presence of racial/ethnic disparities in (a) hypertension management and (b) hypertension outcomes among health center patients. We used data from the 2014 Health Center Patient Survey and performed multilevel logistic regression models to predict hypertension management counseling, patient adherence to counseling and medication regimen, management plan receipt, high blood pressure at last clinical visit, confidence in hypertension self‐management, and hypertension‐related emergency department (ED) episodes or hospitalizations in the past year. We controlled for patient characteristics including age, sex, education, nativity, health behaviors, health care access, and comorbidities. We found significantly higher odds of diet counseling (African Americans, OR: 1.87; Asian Americans, OR: 3.02, AIAN, OR: 2.01), reduced sodium intake (African American, OR: 2.42), and adherence to exercise counseling (African American, OR: 3.52; Asian Americans, OR: 2.93). We also found lower odds of taking hypertension control medication (AIAN, OR: 0.50) and higher odds of hypertension‐related ED visits (African Americans, OR: 3.61, AIAN, OR: 5.31). These results highlight the success of health centers in managing hypertension by race/ethnicity but found adverse hypertension outcomes for some groups. Racial/ethnically tailored efforts might be required to manage hypertension and improve outcomes.

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Racial and Ethnic Differences in Blood Pressure

Cited by 50 publications

References 14 publications

Race/ethnicity determines the relationships between oxidative stress markers and blood pressure in individuals with high cardiovascular disease risk

Race/ethnicity determines the relationships between oxidative stress markers and blood pressure in individuals with high cardiovascular disease risk

Racial and ethnic differences in hypertension

Exploring racial/ethnic disparities in hypertension care among patients served by health centers in the United States

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