This article is more than 5 years old. Information may no longer be current.
Timing of transition from ideal BP varies by sex, race/ethnicity
Click Here to Manage Email Alerts
Net transition probabilities from ideal BP begin during childhood, but the timing of the transition varies by sex and race/ethnicity, according to recent findings.
“Increases in BP have been documented in childhood, with racial/ethnic minorities and young men disproportionately contributing to the total U.S. burden of high BP at younger ages,” Shakia T. Hardy, MPH, of the department of epidemiology at the University of North Carolina at Chapel Hill, and colleagues wrote. “Considering that half of the U.S. population develops high BP by age 60 years, characterizing the ages at which populations transition between BP categories is needed to inform prevention and management efforts.”
Hardy and colleagues used three cross-sectional samples from the National Health and Nutrition Examination Survey, in which participants (aged 8 to 80 years) self-reporting as African American (n = 4,973), white American (n = 8,886) and Mexican American (n = 3,888) were analyzed for transitions from ideal BP, prehypertension and hypertension.
At age 8 years, 86.6% to 88.8% of boys had ideal BP vs. 93% to 96.3% of girls.
Transition variations
The annual net transition probabilities from ideal to prehypertension in men aged 8 to 30 years was twice as great as in women of the same age. In this age group, black men had the largest net transition probability with 2.9% (95% CI, 2.3-3.4), transitioning from ideal BP to prehypertension 1 year later.
Mexican women aged 8 to 30 years had the lowest rate of transition to prehypertension (0.6%; 95% CI, 0.3-0.8).
After age 40 years, the net transition probabilities from ideal BP to prehypertension rapidly increased for women (2.6% to 13%) and stabilized or decreased for men (3% to 4.5%).
Net transition probabilities for prehypertension to hypertension were highest in white boys at about 8 age years and in African American men at about age 25 years.
White women and Mexican Americans had steadily increased net transition probabilities over the life course.
“Large-scale efforts to reduce the burden of elevated BP and its sequelae have principally focused on the clinical management of BP in adults at levels that exceed actionable thresholds,” the researchers wrote. “However, the high net transition probabilities to prehypertension and hypertension at young ages reported herein suggest that the biggest gains in primordial prevention will occur from preventing transitions away from ideal BP in children and young adults more resolutely, thereby necessitating greater clinical and public health efforts to prevent or delay the loss of ideal BP, sustain BP elevation, and disparities in the subpopulations most affected.”
Technology may help
In an accompanying editorial, Herman A. Taylor Jr., MD, MPH, of the Cardiovascular Research Institute at Morehouse School of Medicine, Atlanta, and colleagues wrote: “Mega-studies using personal internet-of-things-enabled devices and unobtrusive wearables could give granular personal and environmental data that would refine our understanding of the emergence of hypertension disparities and their multifactorial causes. Data from personal devices, such as smartphones, could provide insights into additional physical (eg, actigraphy from the smartphone accelerometer) and even psychologic (eg, changes in social network activity) dimensions of behavior and environment, yielding new insights into individualized factors associated with disease genesis and progression.
“The fact that the young are the largest adopters of internet-of-things technology could represent a key opportunity,” Taylor and colleagues concluded. – by Cassie Homer
Disclosure: The researchers and editorial writers report no relevant financial disclosures.
Click Here to Manage Email Alerts