In US, hypertension diagnosis occurs earlier in Black, Hispanic adults
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Among U.S. adults, Black and Hispanic individuals are younger when diagnosed with hypertension compared with white individuals, according to new data from the National Health and Nutrition Examination Survey.
Sadiya S. Khan, MD, MSc, FACC, FAHA, assistant professor of medicine and preventive medicine, associate program director of the cardiovascular disease fellowship and director of research in the section of heart failure at Northwestern University Feinberg School of Medicine, and colleagues conducted a cross-sectional study of 9,627 U.S. adults, representing nearly 75 million Americans, with hypertension from the NHANES from 2011 to 2020.
“Hypertension prevalence is disproportionately higher among non-Hispanic Black adults vs. non-Hispanic white adults ... and may develop at younger ages,” Khan and colleagues wrote. “Earlier age at hypertension onset may mean greater cumulative exposure to high BP across the life course, which is associated with increased risk of CVD, and may contribute to racial disparities in hypertension-related outcomes. We aimed to identify racial and ethnic differences in age at hypertension onset using a contemporary, nationally representative sample.”
The mean age at diagnosis of hypertension was 46 years, and it was younger in Black adults (42 years) and Hispanic adults (43 years) compared with white adults (47 years; P < .01 for both comparisons), according to the researchers.
There was no difference in age at hypertension diagnosis between Asian and white adults (48 years vs. 47 years; P = .86).
Hypertension diagnosis at age 30 or younger occurred more often in Black (25%) and Hispanic (23%) adults compared with white adults (17%; P < .01), Khan and colleagues wrote.
The proportion of adults who were unaware they had hypertension despite having a BP measurement of at least 140/90 mm Hg was 28% among Black individuals, 24% among Asian individuals and 21% among Hispanic individuals, all higher than the 16% of white individuals (P < .01 for all), the researchers found.
“Earlier hypertension onset in Black and Hispanic individuals may contribute to racial and ethnic CVD disparities,” Khan and colleagues wrote. “Greater cumulative exposure of high BP is associated with subclinical and clinical CVD. Potential factors associated with earlier hypertension onset include dietary quality, sedentary behavior and upstream structural and systemic factors (eg, racism, weathering and other environmental exposures). These findings emphasize the importance of hypertension prevention and screening in young adulthood and adolescence.”
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