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Hypertension in blacks

R Cooper1, C Rotimi

  • 1Department of Preventive Medicine and Epidemiology, Loyola University Stritch School of Medicine, Maywood, Illinois 60153, USA. rcooper@wpo.it.luc.edu

American Journal of Hypertension
|July 1, 1997
PubMed
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Hypertension disproportionately affects Black individuals, contributing to health disparities. Risk factors and complications appear similar across racial groups, suggesting environmental influences rather than unique biological traits.

Area of Science:

  • Epidemiology
  • Public Health
  • Cardiovascular Disease Research

Background:

  • Hypertension (high blood pressure) is a significant health concern disproportionately affecting Black populations, contributing to health disparities.
  • Historically, hypertension has been recognized as a major factor in the excess mortality observed among Black individuals.
  • The prevalence ratio of hypertension between Black and White populations has remained constant, suggesting similar impacts of secular trends in causal factors.

Purpose of the Study:

  • To investigate the reasons behind the excess prevalence of hypertension among Black individuals in the United States.
  • To examine whether unique biological or pathophysiological traits contribute to hypertension disparities.
  • To evaluate the role of known risk factors and their distribution across the African diaspora.

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Main Methods:

  • Analysis of cohort study data initiated in the 1970s to assess hypertension's contribution to mortality.
  • Review of national data on hypertension prevalence trends from 1960 to 1990.
  • Comparison of hypertension prevalence and risk factor data across different regions of the African diaspora (West Africa, Caribbean, US).

Main Results:

  • Hypertension accounted for 20% of all-cause mortality in Black individuals compared to 10% in White individuals in a 1970s cohort study.
  • Despite apparent declines in national hypertension prevalence from 1960-1990, the Black:White prevalence ratio remained constant at 1.5.
  • Hypertension prevalence shows a gradient across the African diaspora, with the US having the highest rates (33%), followed by the Caribbean (26%) and West Africa (14%), paralleling gradients in risk factors like obesity.

Conclusions:

  • No unique biological or pathophysiological characteristics of hypertension in Black individuals have been established.
  • Known risk factors for hypertension appear to have similar impacts across different population groups.
  • The excess burden of hypertension among Black individuals in the US is likely attributable to differing mixes and intensities of environmental risk factors, such as obesity, rather than inherent group differences.