Although awareness and treatment levels of high blood pressure have been similar, racial differences in control rates are evident. The higher blood pressure levels for African Americans are associated with higher rates of stroke, end-stage renal disease and congestive heart failure.
Are race differences in blood pressure related to hypertension risk factors?
While the disparities in blood pressure levels, hypertension prevalence and control, and high blood pressure risks are evidence, the factors associated with the race differences are less evident. However, several parameters are proposed that may contribute to the disparities. 33
What are The racial predilections of hypertension in the United States?
1 Asians had the lowest odds of having hypertension 2 Hispanics had the highest odds of having hypertension 3 Puerto Ricans and Central/South Americans had particularly high odds for hypertension 4 Blacks and Asians had higher odds for hypertension compared with whites, but Hispanics did not
What is the difference between black and white blood pressure drugs?
For example, compared to white Caucasians, the black African origin patients exhibit significantly poor BP lowering response to beta-blocker (B drug), ACE inhibitors or ARB’s (A drug), and much better response to CCB (C drug) and diuretics (D drug) when used as monotherapy [9–11].
Is hypertension more common in black people?
Hypertension is a major risk factor for cardiovascular disease and worsens outcomes for people with diabetes or kidney disease (1–4). The 1960s Charleston Heart Study and other cohort studies show higher prevalence of hypertension among black participants than among white participants (5,6).
What race is most affected by high blood pressure?
Rates of High Blood Pressure Control Vary by Sex and Race High blood pressure is more common in non-Hispanic black adults (56%) than in non-Hispanic white adults (48%), non-Hispanic Asian adults (46%), or Hispanic adults (39%).
How hypertension management is affected by ethnicity?
Hypertension awareness, treatment, and control were lowest among Mexican-Americans (68.7%, 58.7%, and 35.5%, respectively) compared with whites (aware: 79.1%, treated: 71.2%, and controlled: 48.6%) and blacks (aware: 80.8%, treated: 71.9%, and controlled: 43.0%).
What blood pressure medication is not good for Black people?
Angiotensin converting enzyme (ACE) inhibitors have been avoided as an initial therapeutic option in the treatment of hypertension in African-Americans. A major reason for this has been the widespread perception of clinicians that these agents have poor blood pressure (BP) lowering efficacy in this population.
Is hypertension more common in whites or blacks?
Studies have consistently reported a higher prevalence of hypertension in blacks than in whites, a main reason for the higher incidence of cardiovascular disease in blacks.
Why do Asians have hypertension?
Lifestyle factors, including diet and stress, may be behind the high hypertension rates in Asia, the researchers said. One common problem is high salt intake. Asians not only tend to have diets high in sodium, but they are genetically more sensitive to sodium.
Why do Latinos have high blood pressure?
The prevalence of hypertension among Hispanic Americans falls between that of blacks and non-Hispanic whites, but appears to increase with the process of acculturation. In addition, the prevalence of hypertension and other cardiovascular risk factors increases with decreasing socioeconomic status.
Why are ACE inhibitors not first line for Black people?
Angiotensin converting enzyme (ACE) inhibitors, β blockers, and angiotensin receptor antagonists are generally less effective as monotherapy in black hypertensives,22,23 because of the tendency towards a low renin state and a lower cardiac output, with increased peripheral resistance.
Why are ACE-I and ARBS not recommended for African black population?
It is commonly reported that the blood pressure lowering efficacy of renin angiotensin system (RAS) inhibitors is attenuated in African Americans due to a greater likelihood of having a low renin profile. Therefore these agents are often not recommended as initial therapy in African Americans with hypertension.
How does race affect hypertension?
Non-Hispanic blacks (NHB) have significantly higher rates of hypertension compared to non-Hispanic whites (NHW), while Hispanics and non-Hispanic Asians (NHA) have lower rates than both groups.
What race has the lowest rate of hypertension?
01). White adults had a significantly lower rate of hypertension than black, Asian, or Hispanic adults: the age-standardized prevalence was 27.5% for white, 43.5% for black, 38.0% for Asian, and 33.0% for Hispanic adults.
What are the causes of early racial differences in blood pressure profile?
Gene/environment interactions should be explored. Target environmental elements should include stress, body weight, and sodium and potassium intake and handling.
Is race difficult to define?
Race and ethnicity are difficult to define and classify. The biology is driven by a complex set of gene/gene, environment/environment, and gene/environment interactions. Among the environmental influences are social issues that may induce stress and potentially influence multiple physiological functions.
What are the factors that contribute to the racial and ethnic disparities of hypertension?
Interactions between genetic and social factors leading to body weight changes, differences in fat distribution (visceral versus subcutaneous), sodium and potassium balance/handling, and nocturnal diuresis may all contribute to the racial and ethnic disparities of hypertension.
What are the differences between blood pressure control rates and blood pressure prevalence?
Non-Hispanic blacks (NHB) have significantly higher rates of hypertension compared to non-Hispanic whites (NHW), while Hispanics and non-Hispanic Asians (NHA) have lower rates than both groups. 2 In an NHANES survey, 3 hypertension control rates among non-Hispanic white adults (55.7%) was significantly higher than NHB (48.5%), NHA (43.5%), and Hispanic (47.4%) adults.
What is the blood pressure threshold for stage 1 hypertension?
The 2017 ACC/AHA hypertension guidelines lowered the blood pressure threshold for diagnosis of stage I hypertension to 130-139/80-89 mm Hg. 1 This change resulted in a substantial increase in the prevalence of hypertension from ~32% to ~46% in the United States (US) adult population. 2 Although the new guidelines comprehensively address how to define, measure, and treat high blood pressure, management of hypertension in special patient groups has not been systematically addressed.
What is the most commonly used antihypertensive drug class?
Overall, diuretics (predominantly thiazide diuretics) were the most commonly utilized antihypertensive drug class accounting for more than one third of all prescriptions throughout the study period ( Table 3 ). At the same time, they were preferentially used in combination therapy compared with other classes. Hispanic patients (60.7%; 95% CI, 57.0%–64.3%) had the lowest utilization rate of antihypertensive medications compared both with whites (73.9%; 95% CI, 71.6%–76.2%) and blacks (70.8%; 95% CI, 68.6%–73.0%). This difference was most pronounced for combination therapy (whites: 45.8%; 95% CI, 43.6%–48.0%; blacks: 48.3%; 95% CI, 45.8%–50.8%; and Hispanics: 34.1%; 95% CI, 30.6%–37.6%). Black patients were most likely to receive combination therapy and they also had the highest average number of antihypertensive medications (whites: 1.78; 95% CI, 1.73–1.82; blacks: 1.91; 95% CI, 1.84–1.97; Hispanics: 1.69; 95% CI, 1.61–1.77).
Why is hypertension a priority in healthcare?
Adequate hypertension control remains a healthcare priority in the United States because of potential large-scale impact on the cardiovascular morbidity and mortality burden. Several studies have reported recent improvements in hypertension awareness, treatment, and control. 1, 15, 16 Our study confirms positive trends in both antihypertensive therapy utilization and hypertension control in all racial groups during the 10-year study period. At the same time, we observed marked racial differences in these measures. Black and Hispanic patients seemed to have poorer hypertension control (as assessed by both JNC 7 and JNC 8 criteria) compared with whites, and these differences were more pronounced in younger and uninsured patients. Although black patients received more intensive antihypertensive therapy, Hispanics were undertreated. Therefore, further efforts should focus on understanding the reasons for racial inequalities in hypertension control and mounting a broader effort in addressing these reasons.
What is the difference between monotherapy and polytherapy?
Monotherapy was defined when a person only reported taking 1 antihypertensive agent. Combination therapy (polytherapy) was defined when a person reported taking >1 antihypertensive agents, including fixed-dose combination agents and combinations of different diuretics.
Abstract
Racial/ethnic minority adults have higher rates of hypertension than non-Hispanic white adults. We examined the prevalence of hypertension among Hispanic and Asian subgroups in New York City.
Introduction
Hypertension is a major risk factor for cardiovascular disease and worsens outcomes for people with diabetes or kidney disease (1–4). The 1960s Charleston Heart Study and other cohort studies show higher prevalence of hypertension among black participants than among white participants (5,6).
Methods
NYC HANES is a population-based, cross-sectional survey of adults in New York City. Data for the most recent survey were collected from August 2013 through June 2014; details of the study design are available elsewhere (12). Briefly, a probability-based, 3-stage clustering design was used to select households in New York City.
Results
The racial/ethnic distribution of NYC HANES 2013–14 was diverse: 35.0% were white, 27.1% were Hispanic, 21.3% were black, and 14.2% were Asian. Asian participants were younger than those in other major racial/ethnic groups ( P = .01) ( Table 1 ).
Discussion
We estimated hypertension prevalence for racial/ethnic groups using a population-based sample of adults in an ethnically/racially diverse urban setting.
Acknowledgments
We thank the people of New York City who participated in the study and the staff who worked tirelessly on the project. The efforts of Drs Trinh-Shevrin, Thorpe, and Islam are partially supported by grant no. P60MD000538 from the National Institutes of Health’s National Institute on Minority Health and Health Disparities and grant no.
Author Information
Corresponding Author: Kezhen Fei, MS, Department of Population Health and Science, Icahn School of Medicine at Mount Sinai, 1 Gustav L. Levy Pl, Box 1077, New York, NY 10029. Telephone: 212-659-9592. Email: [email protected].
How to control high blood pressure?
Try these lifestyle changes to help lower and control your blood pressure. Eat a healthy diet with plenty of fruits and vegetables and reduce the amount of sodium in your diet. ...
What are some examples of blood pressure medications?
Examples are spironolactone (Aldactone, Carospir) and eplerenone (Inspra). How well a drug works for you can depend on your age, sex, race, blood pressure level and overall health.
What are some examples of ACE inhibitors?
There are several ACE inhibitors available. Examples include enalapril (Vasotec, Epaned), lisinopril (Prinivil, Zestril, Qbrelis) and ramipril (Altace). Angiotensin II receptor blockers (ARBs). These drugs block the action of angiotensin, a chemical in your body that narrows your arteries and veins.
What are some examples of beta blockers?
Examples of beta blockers include metoprolol (Lopressor, Toprol-XL), nadolol (Corgard) and atenolol (Tenormin). Renin inhibitors. Renin is a substance produced by your kidneys that triggers a series of steps that increases blood pressure.
What are some examples of calcium channel blockers?
Examples of calcium channel blockers include amlodipine (Norvasc), diltiazem (Cardizem, Tiazac, others), nifedipine (Adalat CC, Procardia) and verapamil (Verelan, Calan). Beta blockers. These drugs work by blocking the effects of the hormone epinephrine, also known as adrenaline.
What are some examples of medications that can cause high blood pressure?
Examples include hydralazine and minoxidil. Aldosterone antagonists. These medications are often used with other drugs, such as a diuretic. Aldosterone antagonists block the hormone aldosterone, which sometimes causes salt and fluid retention, contributing to high blood pressure.
What are the different types of diuretics?
There are three types of diuretics: thiazide, loop and potassium-sparing. Examples of diuretics include chlorothiazide (Diuril), bumetanide (Bumex) and amiloride (Midamor). If diuretics aren't enough to lower your blood pressure, your doctor might recommend adding other blood pressure medications to your treatment.
