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Published on: January 8, 2020

Racial disparity in hypertension control: tallying the death toll

Kevin Fiscella1, Kathleen Holt

  • 1Department of Family Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York 14620, USA. Kevin_Fiscella@urmc.rochester.edu

Annals of Family Medicine
|November 13, 2008
PubMed

Insights

Reducing the systolic blood pressure (SBP) gap between Black and White adults with hypertension could prevent thousands of cardiovascular and cerebrovascular deaths annually among Black Americans. Diligent hypertension management in Black patients is crucial.

Area of Science:

  • Public Health
  • Cardiovascular Medicine
  • Health Disparities

Background:

  • Black Americans with hypertension exhibit poorer blood pressure control compared to White Americans.
  • The mortality impact of this racial disparity in hypertension control remains largely unquantified.

Purpose of the Study:

  • To assess differences in systolic blood pressure (SBP) control between Black and White adults diagnosed with hypertension.
  • To quantify the impact of this SBP disparity on cardiovascular and cerebrovascular mortality among Black adults.

Main Methods:

  • Utilized SBP data from the National Health and Nutrition Examination Survey (1999-2002).
  • Modeled mortality rate changes by reducing mean SBP in Black adults to White levels.
  • Employed meta-analyses for mortality estimates and SBP treatment trial data.

Main Results:

  • Mean SBP was ~6 mm Hg higher in Black adults with hypertension than the general Black population and ~7 mm Hg higher than in White adults with hypertension.
  • Equalizing SBP between Black and White hypertensive adults could prevent an estimated 5,480 annual heart disease deaths and 2,190 annual stroke deaths among Black Americans.
  • The study included 1,545 Black and 1,335 White adults with available SBP measurements.

Conclusions:

  • Eliminating racial disparities in blood pressure control significantly reduces mortality from heart disease and stroke in Black adults.
  • Primary care clinicians must be particularly attentive to managing hypertension in Black patients to address these disparities.
Abstract

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