Racial differences in hypertension: implications for high blood pressure management

Abstract

The racial disparity in hypertension and hypertension-related outcomes has been recognized for decades with African Americans with greater risks than Caucasians. Blood pressure levels have consistently been higher for African Americans with an earlier onset of hypertension. Although awareness and treatment levels of high blood pressure have been similar, racial differences in control rates are evident. The higher blood pressure levels for African Americans are associated with higher rates of stroke, end-stage renal disease and congestive heart failure. The reasons for the racial disparities in elevated blood pressure and hypertension-related outcomes risk remain unclear. However, the implications of the disparities of hypertension for prevention and clinical management are substantial, identifying African American men and women with excel hypertension risk and warranting interventions focused on these differences. In addition, focused research to identify the factors attributed to these disparities in risk burden is an essential need to address the evidence gaps.

Figures

Figure 1

Prevalence of hypertension (percent of adult population). U.S. 1988-94 and 1999-2004 Adapted from: Cutler JA, Sorlie PD, Wolz M, Thom T, Fields LE, Roccella EJ. Trends in Hypertension Prevalence, Awareness, Treatment, and Control Rates in United States Adults Between 1988 –1994 and 1999 –2004. Hypertension. 2008;52:818-827; and Guo F, He D, Zhang W, Walton G. Trends in prevalence, awareness, management, and control of hypertension among United States adults 1999 to 2010. J AM Coll Cardiol 2012;60:599-606

Figure 2

Percent of hypertensive adult population with controlled blood pressure levels. U.S. 1988-94, 1999-2004 and 2009-10 Adapted from: Cutler JA, Sorlie PD, Wolz M, Thom T, Fields LE, Roccella EJ. Trends in Hypertension Prevalence, Awareness, Treatment, and Control Rates in United States Adults Between 1988 –1994 and 1999 –2004. Hypertension.2008;52:818-827; and Guo F, He D, Zhang W, Walton G. Trends in prevalence, awareness, management, and control of hypertension among United States adults 1999 to 2010. J AM Coll Cardiol 2012;60:599-606