Blood pressure control and mortality in US- and foreign-born blacks in New York City

Area of Science:

• Cardiovascular Health
• Epidemiology
• Health Disparities

Background:

• Hypertension is a significant global health issue.
• Understanding variations in hypertension outcomes among different Black populations is crucial for effective public health strategies.

Purpose of the Study:

• To compare blood pressure (BP) control and all-cause mortality between US-born and foreign-born Black individuals with hypertension.
• To identify potential disparities in hypertension management and outcomes within the Black population.

Main Methods:

• Retrospective cohort study utilizing data from 41,868 hypertensive patients in a New York City public healthcare system (2004-2009).
• BP control defined by last recorded measurement and mean BP control.
• Poisson regression analysis was used to compare BP control rates and mortality hazards.

Main Results:

• Caribbean-born Blacks had significantly lower BP control rates (last BP measurement: 49%) compared to US-born (54%) and West African-born Blacks (57%).
• Caribbean-born and West African-born Blacks exhibited reduced hazard ratios for all-cause mortality (0.46 and 0.28, respectively) compared to US-born Blacks, even after adjusting for BP.
• Significant heterogeneity in BP control and mortality was observed within the Black population.

Conclusions:

• Caribbean-born Blacks demonstrated worse BP control than US-born Blacks.
• Despite worse BP control, foreign-born Black groups experienced lower mortality, suggesting complex interactions beyond BP levels.
• Hypertension management strategies must consider the diverse origins and associated health outcomes within the Black population.