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Error bars indicate 95% confidence intervals. Data are weighted to the US population.
Hajjar I, Kotchen TA. JAMA. 2003;290:199-206.
Increasing Prevalence of Hypertension: Rise From 1988 to 2000 (NHANES)
• Environmental factors ultimately related to race (e.g. socioeconomic disadvantage, less access to health care) play roles in causing and sustaining hypertension 1, 2 • Despite similar African heritage, Africans living in Africa or West Indies have much less hypertension than African Americans 3,4 • In rural Africa, hypertension prevalence is very low and blood pressure does not rise with age as it does in all ethnic groups in US 3
Men Women
Ethnic/Racial Differences in Prevalence of Hypertension
• Blacks have a higher prevalence and incidence of hypertension than whites. Most studies in the United Kingdom and the United States report a higher prevalence and lower awareness of hypertension in black people than in white people.
175/105
Prevalence of Hypertension Increases with Age: NHANES 1999-2000 Data
Non-Hispanic White 100
Non-Hispanic Black 100
Mexican American
Hypertension* Prevalence (%) Hypertension* Prevalence (%)
• American Indians/Alaska Natives
21.2% 29.2% 19.6% 16.9% 20.7% 25.4%
American Heart Association Heart Disease and Stroke Statistics 2007
Contributing Factors: Social, Environmental, or Genetic?
% Increase (1988–1994 to 1999–2000)
5 4.5
4 3.5
3
2.5 2
1.5 1
0.5 0
Non-Hispanic Whites
Non-Hispanic Blacks
Mexican Americans
NHANES = National Health and Nutrition Examination Survey. Fields, LE et al. Hypertension. 2004;44:398-404.
mortality
4
risk 3
2
4x 2x
1
0 115/75
135/85
155/95
SBP/DBP (mm Hg)
*Individuals aged 40-69 years, starting at blood pressure 115/75 mm Hg. CV, cardiovascular; DBP, diastolic blood pressure; SBP, systolic blood pressure. Chobanian AV et al. JAMA. 2003;289(19):2560-2572. Lewington S et al. Lancet. 2002;360(9349):1903-1913.
80
80
60
60
40
40
20
20
0
18-39 40-59
≥60
0
18-39 40-59
≥60
Men (age, years)
Women (age, years)
*Hypertension defined as a BP of ≥140/90 mm Hg or reported use of antihypertensives.
Hypertension Prevalence by Ethnic/Minority Groups
• Group Prevalence
HTN
• White
• Black/African-American
• Hispanic/Latino
• Asians
• Native Hawaiian/other Pacific Islander
What Is Hypertension?
JNC 7 Definitions
Blood Pressure (mm Hg)
Systolic
Diastolic
<120
and <80
120-139
or 80-89
140-159
or 90-99
≥160
or ≥100
Category
Normal Prehypertension Stage 1 hypertension Stage 2 hypertension
பைடு நூலகம்
Chobanian AV, et al. Hypertension 2003;42:1206-52
Cardiovascular Mortality Risk Doubles With Each 20-mm Hg SBP or 10-mmHg DBP Increment*
8x
8
7
6
Cardiovascular 5
• In Mexican-Americans, the prevalence and incidence of hypertension is similar to or lower than in whites. NHANES III reported an ageadjusted prevalence of hypertension at 20.6% in Mexican-Americans and 23.3% in non-Hispanic whites.
