Sex difference in blood pressure among South Asian diaspora in Europe and North America and the role of BMI: a meta-analysis

Munter, Jeroen S. L. de; Agyemang, Charles; Valkengoed, Irene G. M. van; Bhopal, Raj; Stronks, Karien

doi:10.1038/jhh.2010.77

Cited by 10 publications

(9 citation statements)

References 28 publications

(65 reference statements)

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“…However, these important factors affect prevalence and need explanation. Although we found no sex difference, studies have examined the role of sex as a determinant of blood pressure and found lower prevalence among females [40], [41]. We found that hypertension was more prevalent, albeit non-significantly, in the older age group (>45 years) which was contrary to the conventional knowledge that blood pressure doesn't increase with age in tribal populations [4], [10], [32].…”

Section: Discussioncontrasting

confidence: 99%

Prevalence of Hypertension in Indian Tribes: A Systematic Review and Meta-Analysis of Observational Studies

Rizwan

Kumar²,

Singh

et al. 2014

PLoS ONE

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IntroductionIn India there is an increasing trend in hypertension prevalence among the general population. Studies have shown that tribal populations in India are also experiencing this burden.ObjectiveThe aim was to estimate the pooled prevalence of primary hypertension among adult tribal populations of India.MethodsA systematic search was conducted in MEDLINE, IndMed, Web of Science, Google Scholar and major journals for studies published between 1981 and 2011. Two authors independently reviewed the studies, did quality assessment and extracted data in pre-coded spread-sheets. Pooled estimates of prevalence of hypertension were calculated using DerSimonian-Laird random effects model. Subgroup and sensitivity analyses and meta-regression were performed.ResultsTwenty studies or 53 subpopulations with 64 674 subjects were included in final review. The pooled estimate of hypertension prevalence was 16.1% (95% CI: 13.5, 19.2). There was significant heterogeneity among the studies (I2 = 99% and Q = 4624.0, df = 53, p<0.001). Subgroup analyses showed that year of study, acculturation status, special features, and BP measurement techniques significantly influenced prevalence, but after meta-regression analyses, ‘decade of study’ remained the only covariate that significantly and independently influenced prevalence (R2 = 0.57, Q = 119.2, df = 49, p value <0.001).ConclusionAn increasing trend was found in the prevalence of hypertension in adult tribal populations across three decades. Although acculturation was probably the underlying agent that caused this increase, other unmeasured factors that need further research were also important. Concerned policy makers should focus on the changing health needs of tribal communities.

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Section: Discussioncontrasting

confidence: 99%

Prevalence of Hypertension in Indian Tribes: A Systematic Review and Meta-Analysis of Observational Studies

Rizwan

Kumar²,

Singh

et al. 2014

PLoS ONE

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“…On the other hand, high prevalence of cardiovascular risk in women was also reported by other studies [47-49]. The higher prevalence of diabetes among females was also indicated in previous research [50, 51]. …”

Section: Discussionsupporting

confidence: 79%

Prevalence of Pragmatically Defined High CV Risk and its Correlates in LMIC: A Report From 10 LMIC Areas in Africa, Asia, and South America

Carrillo‐Larco

Miranda

Cui

et al. 2016

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Background Current available tools for assessing high cardiovascular risk (HCR) often require measurements not available in resource-limited settings in low- and middle-income countries (LMICs). There is a need to assess HCR using a pragmatic evidence-based approach. Objective To report the prevalence of HCR in ten LMIC areas in Africa, Asia and South America, and to investigate the profiles and correlates of HCR. Methods Cross-sectional analysis using data from the NHLBI-UHG Centers of Excellence. HCR was defined as history of heart disease/heart attack, history of stroke, older age (≥50 years for men and ≥60 for women) with history of diabetes, or older age with systolic blood pressure ≥160 mmHg. Prevalence estimates were standardized to the WHO World Standard Population. Results A total of 37,067 subjects aged ≥35 years were included; 53.7% were women and mean age was 53.5 (±12.1) years. The overall age-standardized prevalence of HCR was 15.4% (95% CI: 15.0-15.7), ranging from 8.3% (India, Bangalore) to 23.4% (Bangladesh). Among men, the prevalence was 1.7% for the younger age group (35-49 years) and 29.1% for the older group (≥50); among women, 3.8% for the younger group (35-59 years) and 40.7% for the older group (≥60). Among the older group, measured systolic blood pressure ≥160 mmHg (with or without other conditions) was the most common criterion for having HCR, followed by diabetes. The proportion of having met more than one criterion was nearly 20%. Age, education, and body mass index were significantly associated with HCR. Cross-site differences existed and were attenuated after adjusting for age, sex, education, smoking, and body mass index. Conclusions The prevalence of HCR in ten LMIC areas was generally high. This study provides a starting point to define targeted populations that may benefit from interventions combining both primary and secondary prevention strategies.

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“…The hypertension-related disease burden represents a major global public health challenge, with significant race and gender differences in the prevalence of hypertension across various sociodemographic subgroups among human populations worldwide (1–3). Blacks surpass other ethnic groups in the United States with respect to the prevalence, early onset, and severity of hypertension (1,2,4).…”

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confidence: 99%

“…Blacks surpass other ethnic groups in the United States with respect to the prevalence, early onset, and severity of hypertension (1,2,4). Men have higher blood pressure (BP) levels than women in most populations (3). The black-white and gender differences in BP even occur in childhood (5–8), with black children showing higher levels and faster rate of change than white children (5,6).…”

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confidence: 99%

Race and Sex Differences of Long-Term Blood Pressure Profiles From Childhood and Adult Hypertension

Shen

Zhang

et al. 2017

Hypertension

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This study aims to characterize longitudinal blood pressure (BP) trajectories from childhood in black-white and gender groups and examine the association between childhood level-independent trajectories of BP and adult hypertension. The longitudinal cohort consisted of 2,732 adults who had body mass index and BP measured 4–15 times from childhood (4–19 years) to adulthood (20–51 years). Model-estimated levels and linear slopes of BP and BMI at childhood age points were calculated at one-year intervals using the growth curve parameters and their first derivatives, respectively. Linear and nonlinear curve parameters differed significantly between race-gender groups; BP levels showed race and gender differences from age 15 years onwards. Hypertensives had higher long-term BP levels than normotensives in race-gender groups. Although linear and nonlinear slope parameters of BP were race- and gender-specific, they differed consistently, significantly between hypertension and normotension groups. BP trajectories during young adulthood (20–35 years) were significantly greater in hypertensives than in normotensives; however, the trajectories during middle-aged adulthood (36–51 years) were significantly smaller in hypertensives than in normotensives. Level-independent linear slopes of systolic BP showed significantly negative associations (odds ratio=0.50~0.76, p<0.001) during pre-puberty period (4–11 years) but significantly positive associations (odd ratio=1.44~2.80, p<0.001) during the puberty period (13–19 years) with adult hypertension, adjusting for covariates. These associations were consistent across race-gender groups. These observations indicate that adult hypertension originates in childhood, with different longitudinal BP trajectory profiles during young and middle-aged adulthood in black-white and gender groups. Puberty is a crucial period for the development of hypertension in later life.

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Sex difference in blood pressure among South Asian diaspora in Europe and North America and the role of BMI: a meta-analysis

Cited by 10 publications

References 28 publications

Prevalence of Hypertension in Indian Tribes: A Systematic Review and Meta-Analysis of Observational Studies

Prevalence of Hypertension in Indian Tribes: A Systematic Review and Meta-Analysis of Observational Studies

Prevalence of Pragmatically Defined High CV Risk and its Correlates in LMIC: A Report From 10 LMIC Areas in Africa, Asia, and South America

Race and Sex Differences of Long-Term Blood Pressure Profiles From Childhood and Adult Hypertension

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