Blacks have more incidences of hypertension at midlife

Black men and women have higher incidences of hypertension by the age of 55 compared to white men and women, according to a study published July 11 in the Journal of the American Heart Association.

“Regardless of blood pressure levels in young adulthood, blacks have a substantially higher risk for developing high blood pressure compared with whites through 55 years of age,” said S. Justin Thomas, PhD, of the University of Alabama at Birmingham, in a prepared statement issued by the American Heart Association. “It is urgent that healthcare providers counsel young patients, particularly blacks, about eating a healthy diet, being physically active and controlling body weight. The risk of high blood pressure can be significantly reduced with a healthy lifestyle.”

Thomas and colleagues sought to determine incidences of hypertension in both blacks and whites, ages 18 to 30, who were followed until 55. Additionally, they sought to identify the risk factors associated with a higher risk for hypertension.

The cohort included 3,890 participants from the Coronary Artery Risk Development in Young Adults (CARDIA) study. Hypertension was defined using the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) blood pressure guidelines—meaning blood pressure readings greater than or equal to 130/80 mmHg.

They found 75 percent of both black men and women developed high blood pressure by the age of 55, compared to 55 percent of white men and 40 percent of white women.

“Higher BMI, cigarette smoking, parental history of hypertension, lower level of education, higher alcohol use, and higher serum uric acid level are well-established risk factors for hypertension,” the researchers wrote. “Most of these risk factors are more common among blacks compared with whites.”

Additionally, the researchers wrote, blacks still had 1.5- to two-fold increased risk for hypertension after adjusting for variables.

Higher body weight among the cohort was associated with an increased risk for high blood pressure, regardless of race or gender. The researchers associated better adherence to the Dietary Approaches to Stop Hypertension (DASH) die with a lower risk for hypertension.

“The finding that blacks with systolic blood pressure/diastolic blood pressure of less than 110/70 mm Hg at baseline (i.e., when participants were aged 18–30 years) have a higher risk for developing hypertension than their white counterparts suggests that racial disparities in hypertension are not solely attributed to higher BP levels beginning in childhood,” Thomas et al. wrote. “Racial differences in factors, including the maintenance of health behaviors, may also play an important role in the higher incidence of hypertension in blacks compared with whites.”