NHLBI workshop panel discussion: a scientific perspective

THE WORKSHOP ON THE EPIDEMIOLOGY OF HYPERTENSION in Hispanic Americans, Native Americans, and Asian/Pacific Islander Americans concluded with a panel discussion of the findings from a scientific perspective. Panel members presented their ideas for research direction on measuring and identifying more accurately the frequency, distribution, and determinants of hypertension in minority populations, evaluating mechanisms leading to hypertension, and identifying the implications for public health and medical practice. Several members stressed the need for additional data collections, using standardized methods. They stated that future studies, including longitudinal ones, should target specific ethnic populations and subpopulations and address the role of acculturation, assimilation, modernization, and socio-economic status. They also recommended comparative and collaborative studies among groups. They emphasized the importance of obesity and diabetes or impaired glucose tolerance as determinants of hypertension in all three populations, and suggested that there may be differences in the etiology and pathophysiology of hypertension among the groups, with visceral adiposity or insulin resistance syndrome being more important in Asian populations. The potential for identification of genes involved in blood pressure variation and hypertension risk may help understand the interaction of genes with the environment. Minority groups in the United States share the problem of high prevalence of high blood pressure and low rates of control. For this reason, the panel urged a new era of community-based, culturally sensitive prevention and control projects.