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Hypertension risk increases in black patients despite BP level in young adulthood
Black patients had a higher risk for hypertension through age 55 years compared with white patients regardless of BP during young adulthood, according to a study published 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,” S. Justin Thomas, PhD, assistant professor in the department of psychiatry at University of Alabama at Birmingham, said in a press release. “It is urgent that health care 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.”
Researchers analyzed data from 3,890 participants (mean age, 25 years; 42% men; 49% black) from the CARDIA study. Participants in this study were excluded if they had a systolic BP greater than 130 mm Hg, a diastolic BP greater than 80 mm Hg, a self-reported previous hypertension diagnosis or self-reported use of antihypertensive medications.
The baseline clinic visit was performed in 1985-1986 and included an exercise treadmill test, BP measurements, height and weight measurements, Dietary Approaches to Stop Hypertension (DASH) diet adherence, smoking and alcohol status, sex, age, race, education and parental history of hypertension. This study included follow-up clinic visits that were completed 2, 5, 7, 10, 15, 20, 25 and 30 years after the baseline examination.
By age 55 years, the cumulative incidence of hypertension was 75.5% in black men, 75.7% in black women, 54.5% in white men and 40% in white women.
Black participants were more likely to develop hypertension compared with white participants, as shown in multivariable-adjusted HRs for those with BP less than 110 mm Hg/70 mm Hg (adjusted HR = 1.97; 95% CI, 1.65-2.35), 110-119 mm Hg/70-74 mm Hg (aHR = 1.8; 95% CI, 1.52-2.14) and 120-129 mm Hg/75-79 mm Hg (aHR = 1.59; 95% CI, 1.31-1.93).
An increased risk for hypertension in white and black participants was linked to parental history of hypertension and higher BMI, systolic BP, diastolic BP and serum uric acid. A decreased risk for hypertension in black and white participants was associated with a higher adherence to a DASH diet.
“These findings also underscore the importance of focusing on modifiable risk factors, including BMI and adherence to a DASH diet, at an early age for the prevention of hypertension,” Thomas and colleagues wrote. – by Darlene Dobkowski
Disclosures: The authors report no relevant financial disclosures.