Racial/ethnic differences in prehypertension in American adults: Population and relative attributable risks of abdominal obesity

Abstract

To estimate the risk and population attributable risk of prehypertension that is due to abdominal obesity in White, Black and Hispanic American adults. To determine how much of the relative difference in the risk of prehypertension between high-risk Blacks and Hispanics and the low-risk group Whites that is attributable to their differences in abdominal obesity. Data (n ¼ 4016) from the 1999 to 2000 US National Health and Nutrition Examination Surveys were used in this study. Abdominal obesity was defined as waist circumference X102 and X88 cm in men and women, respectively. Prehypertension was defined as not being on antihypertensive medication and having systolic blood pressure of 120-139 mmHg or diastolic blood pressure of 80-89 mmHg. Odds ratio from the logistic regression analysis was used to estimate the risk of prehypertension that was due to abdominal obesity. To estimate prehypertension risk differences between low-risk Whites and high-risk Blacks and Hispanics that was due to abdominal obesity, we estimated relative attribu- The analogous values for women were B39.7 and B16.5%, respectively. In conclusion, despite having lower rates of abdominal obesity than their counterparts, Black men, Hispanic men and Hispanic women had high population attributable risks, indicating that factors other than abdominal obesity may have important explanatory power for racial differences in prehypertension in these groups. However, in Black women reduction in risk of prehypertension could be possible by instituting public health measures to reduce abdominal obesity to the levels seen in White women. Intervention programmes designed to reduce overall obesity may also lead to reduction of abdominal obesity, and consequently may curb prehypertension in these population groups. Lifestyle modification, including diet and exercise, may have public health significance in reducing the incidence of prehypertension in these populations.

Should obesity be blamed for the high prevalence rates of hypertension in black South African women?

“…But it is striking that even though the black South Africans have higher BPs, vascular resistance, fibrinogen and leptin levels than Caucasian women, the relationships of these risk markers with obesity are significantly weaker than those of Caucasians. Okosun et al 22 found opposite results, namely that abdominal obesity of African-American women was more strongly associated with increased odds of prehypertension than for Caucasian women. However, it remains uncertain as to what extent South African and African-American populations could be compared.…”

Prehypertension Among Middle-Aged and Elderly People in Taiwan: A Five-Year Follow-Up

“…Due to the relatively older age and small study sample, further study is needed to clarify when prehypertension is of the same prognostic value in older people as in the adult and middle-aged population. In addition, it has been reported that DM and impaired glucose tolerance were significantly increased in prehypertensive subjects, and their influences extended into hypertensive subjects 27,28) . There are several limitations in this study.…”

Racial Disparity in Blood Pressure: is Vitamin D a Factor?

“…Previous studies have suggested that diet, obesity, social support, and stress may contribute, but these factors do not seem to fully explain higher Black BP. [2][3][4] Vitamin D is critical to bone health, but ubiquitous vitamin D receptors and effects on myriads of genes suggest broader clinical effects. 5 Genetic knockout models suggest vascular effects of vitamin D, including vascular endothelium, the renin-angiotensin axis, 6 and vascular smooth muscle including cell proliferation, 7 inflammation, 6 thrombosis, 8 cardiac hypertrophy, 9 and hyperparathyroid hormone secretion.…”