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Hypertension in minority populations: new guidelines and emerging concepts

Fátima Rodriguez1, Keith C Ferdinand1

  • 1Department of Cardiovascular Medicine, Stanford University, Palo Alto, CA; and Heart and Vascular Institute, Tulane University School of Medicine, New Orleans, LA.

Advances in Chronic Kidney Disease
|February 24, 2015
PubMed

Insights

Racial and ethnic disparities in hypertension and chronic kidney disease (CKD) are influenced by social factors and emerging biological elements. Multidimensional treatment approaches are proposed for diverse US populations, including African Americans and Hispanics.

Area of Science:

  • Cardiovascular Medicine
  • Nephrology
  • Public Health

Background:

  • Persistent disparities in hypertension, chronic kidney disease (CKD), and cardiovascular disease exist among US racial/ethnic minority groups.
  • While social determinants of health are primary mediators, emerging data suggest biological factors also contribute to these health disparities.
  • Race is a social construct, and ethnicity definitions are imprecise, yet race/ethnicity categories aid in interpreting health data and ensuring clinical trial generalizability.

Purpose of the Study:

  • To review hypertension epidemiology, pathophysiology, and management in diverse US minority populations, focusing on African Americans and Hispanics.
  • To highlight the intersection of hypertension and CKD, particularly in African Americans.
  • To propose multidimensional treatment strategies for hypertension in diverse populations.

Main Methods:

  • Literature review exploring existing data on hypertension and CKD in US racial/ethnic minority groups.
  • Analysis of the interplay between social determinants of health, potential biological factors, and health outcomes.
  • Synthesis of current understanding and proposal of integrated treatment approaches.

Main Results:

  • Hypertension and CKD disparities are significant, influenced by both social and biological factors.
  • African Americans experience a high burden of hypertension and CKD, underscoring the need for targeted research and interventions.
  • Heterogeneity exists within racial/ethnic groups, suggesting a need for nuanced approaches beyond broad categorizations.

Conclusions:

  • Addressing hypertension and CKD disparities requires understanding the complex interplay of social, biological, and genetic factors.
  • Multidimensional treatment strategies involving population, community, health system, and individual levels are essential for diverse populations.
  • Further research is needed to elucidate biological mechanisms and refine interventions for specific minority groups.

Keywords:
Chronic kidney diseaseDisparitiesGuidelinesHypertensionRacial/ethnic minorities

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