Physical Activity and Ethnic Differences in Hypertension Prevalence in the United States

Worldwide, large differences exist in the prevalence of hypertension and hypertension-related complications, both along geographic boundaries and between different ethnic groups. Urbanization and dietary changes have led to a genuine increase in hypertension prevalence in many low- and middle-income countries, whereas migration has been associated with disparities in hypertension prevalence, awareness, and control in different, large multi-ethnic populations in Europe and the United States. Depending on the geographic area and definition of ethnicity, results can be quite heterogeneous and are susceptible to generalization. However, data in both Europe and the United States consistently show higher prevalence rates of hypertension and hypertension-related complications in populations of West African descent. These ethnic differences in hypertension susceptibility may in part be attributable to quantitative differences in other risk factors such as obesity and dietary salt intake, but may also relate to differences in pathophysiological traits, particularly increased salt sensitivity and vascular contractility. This may also explain the better blood pressure-lowering potential of salt restriction and of pharmacological treatment with diuretics and calcium channel blocking agents, whereas renin–angiotensin system blockers and beta-blocking agents are in general less effective. The European Society of Hypertension/European Society of Cardiology Guidelines recommend to start with calcium channel blockers or a thiazide diuretic for the treatment of hypertension in sub-Saharan African populations if no other compelling indications are present, while there is a lack of evidence that ethnicity should influence the preference for particular blood pressure-lowering combinations. The realization that ethnic differences in hypertension prevalence and treatment response exist may help to increase our understanding of the complex pathophysiology of hypertension and improve strategies aimed at the selection and control of hypertensive patients with different ethnic background.

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IMPROVING HYPERTENSION CONTROL IN THE UNITED STATES: UNDERSTANDING RACIAL/ETHNIC DIFFERENCES IN THE BLOOD PRESSURE CASCADE

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(21)02833-3 ◽

2021 ◽

Vol 77 (18) ◽

pp. 1475

Author(s):

Rahul Aggarwal ◽

Nicholas Chiu ◽

Rishi Wadhera ◽

Andrew Moran ◽

Changyu Shen ◽

...

Keyword(s):

United States ◽

Blood Pressure ◽

Ethnic Differences ◽

The United States ◽

Hypertension Control ◽

Racial Ethnic

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Effects of trees, gardens, and nature trails on heat index and child health: design and methods of the Green Schoolyards Project

BMC Public Health ◽

10.1186/s12889-020-10128-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Kevin Lanza ◽

Melody Alcazar ◽

Deanna M. Hoelscher ◽

Harold W. Kohl

Keyword(s):

Physical Activity ◽

United States ◽

Relative Humidity ◽

Air Temperature ◽

The United States ◽

Heat Index ◽

Activity Levels ◽

Natural Setting ◽

Physical Activity Levels ◽

Nature Trails

Abstract Background Latinx children in the United States are at high risk for nature-deficit disorder, heat-related illness, and physical inactivity. We developed the Green Schoolyards Project to investigate how green features—trees, gardens, and nature trails—in school parks impact heat index (i.e., air temperature and relative humidity) within parks, and physical activity levels and socioemotional well-being of these children. Herein, we present novel methods for a) observing children’s interaction with green features and b) measuring heat index and children’s behaviors in a natural setting, and a selection of baseline results. Methods During two September weeks (high temperature) and one November week (moderate temperature) in 2019, we examined three joint-use elementary school parks in Central Texas, United States, serving predominantly low-income Latinx families. To develop thermal profiles for each park, we installed 10 air temperature/relative humidity sensors per park, selecting sites based on land cover, land use, and even spatial coverage. We measured green features within a geographic information system. In a cross-sectional study, we used an adapted version of System for Observing Play and Recreation in Communities (SOPARC) to assess children’s physical activity levels and interactions with green features. In a cohort study, we equipped 30 3rd and 30 4th grade students per school during recess with accelerometers and Global Positioning System devices, and surveyed these students regarding their connection to nature. Baseline analyses included inverse distance weighting for thermal profiles and summing observed counts of children interacting with trees. Results In September 2019, average daily heat index ranged 2.0 °F among park sites, and maximum daily heat index ranged from 103.4 °F (air temperature = 33.8 °C; relative humidity = 55.2%) under tree canopy to 114.1 °F (air temperature = 37.9 °C; relative humidity = 45.2%) on an unshaded playground. 10.8% more girls and 25.4% more boys interacted with trees in September than in November. Conclusions We found extreme heat conditions at select sites within parks, and children positioning themselves under trees during periods of high heat index. These methods can be used by public health researchers and practitioners to inform the redesign of greenspaces in the face of climate change and health inequities.

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Nutrition and physical activity recommendations from the United States and European cardiovascular guidelines: a comparative review

Current Opinion in Cardiology ◽

10.1097/hco.0000000000000763 ◽

2020 ◽

Vol 35 (5) ◽

pp. 508-516 ◽

Cited By ~ 1

Author(s):

Richard A. Ferraro ◽

Nicole Mercado Fischer ◽

Helen Xun ◽

Erin D. Michos

Keyword(s):

Physical Activity ◽

United States ◽

The United States ◽

Comparative Review ◽

Physical Activity Recommendations ◽

Nutrition And Physical Activity ◽

Activity Recommendations

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Physical Activity Among Somali Men in Minnesota

American Journal of Men s Health ◽

10.1177/1557988313489132 ◽

2013 ◽

Vol 8 (1) ◽

pp. 35-44 ◽

Cited By ~ 23

Author(s):

Ahmed A. Mohamed ◽

Abdullahi M. Hassan ◽

Jennifer A. Weis ◽

Irene G. Sia ◽

Mark L. Wieland

Keyword(s):

Physical Activity ◽

United States ◽

Community Based Participatory Research ◽

The United States ◽

Success Stories ◽

Semistructured Interviews ◽

High Knowledge ◽

African Refugee ◽

Competing Priorities ◽

Exercise Equipment

Immigrants and refugees arrive to the United States healthier than the general population, but this advantage declines with increasing duration of residence. One factor contributing to this decline is suboptimal physical activity, but reasons for this are poorly understood. Persons from Somalia represent the largest African refugee population to the United States, yet little is known about perceptions of physical activity among Somali men. Somali members of a community-based participatory research partnership implemented three age-stratified focus groups and three semistructured interviews among 20 Somali men in Rochester, Minnesota. Team-based inductive analysis generated themes for barriers and facilitators to physical activity. Barriers to physical activity included less walking opportunities in the United States, embarrassment about exercise clothing and lack of familiarity with exercise equipment/modalities, fear of harassment, competing priorities, facility costs, transportation, and winter weather. Facilitators to physical activity included high knowledge about how to be active, success stories from others in their community as inspiration, and community cohesion. Findings may be used to derive interventions aimed to promote physical activity among Somali men in the United States.

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Leisure-time, occupational, household physical activity and insulin resistance (HOMAIR) in the Midlife in the United States (MIDUS) national study of adults

Preventive Medicine Reports ◽

10.1016/j.pmedr.2016.12.025 ◽

2017 ◽

Vol 5 ◽

pp. 224-227 ◽

Cited By ~ 5

Author(s):

Vera K Tsenkova

Keyword(s):

Physical Activity ◽

United States ◽

Insulin Resistance ◽

Leisure Time ◽

The United States ◽

National Study ◽

Household Physical Activity

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Differential correlates of physical activity in urban and rural adults of various socioeconomic backgrounds in the United States

Journal of Epidemiology & Community Health ◽

10.1136/jech.57.1.29 ◽

2003 ◽

Vol 57 (1) ◽

pp. 29-35 ◽

Cited By ~ 389

Author(s):

S E Parks

Keyword(s):

Physical Activity ◽

United States ◽

The United States ◽

Rural Adults

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Accelerometer-derived physical activity and sedentary time by cancer type in the United States

PLoS ONE ◽

10.1371/journal.pone.0182554 ◽

2017 ◽

Vol 12 (8) ◽

pp. e0182554 ◽

Cited By ~ 36

Author(s):

Keith M. Thraen-Borowski ◽

Keith P. Gennuso ◽

Lisa Cadmus-Bertram

Keyword(s):

Physical Activity ◽

United States ◽

Sedentary Time ◽

The United States ◽

Cancer Type

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Racial/Ethnic Disparities in Hypertension Prevalence, Awareness, Treatment, and Control in the United States, 2013 to 2018

Hypertension ◽

10.1161/hypertensionaha.121.17570 ◽

2021 ◽

Author(s):

Rahul Aggarwal ◽

Nicholas Chiu ◽

Rishi K. Wadhera ◽

Andrew E. Moran ◽

Inbar Raber ◽

...

Keyword(s):

United States ◽

Ethnic Disparities ◽

The United States ◽

Self Report ◽

Similar Treatment ◽

Hypertension Prevalence ◽

Health And Nutrition ◽

Race Ethnicity ◽

And Control ◽

White Adults

We evaluated the prevalence, awareness, treatment, and control of hypertension (defined as a systolic blood pressure [BP]) ≥140 mm Hg, diastolic BP ≥90 mm Hg, or a self-reported use of an antihypertensive agent) among US adults, stratified by race/ethnicity. This analysis included 16 531 nonpregnant US adults (≥18 years) in the three National Health and Nutrition Examination Survey cycles between 2013 and 2018. Race/ethnicity was defined by self-report as White, Black, Hispanic, Asian, or other Americans. Among 76 910 050 (74 449 985–79 370 115) US adults with hypertension, 48.6% (47.3%–49.8%, unadjusted) have controlled BP. When compared with BP control rates for White adults (49.0% [46.8%–51.2%], age-adjusted), BP control rates are lower in Black (39.2%, adjusted odds ratio [aOR], 0.71 [95% CI, 0.59–0.85], P <0.001), Hispanic (40.0%, aOR, 0.71 [95% CI, 0.58–0.88], P =0.003), and Asian (37.8%, aOR, 0.68 [95% CI, 0.55–0.84], P =0.001) Americans. Black adults have higher hypertension prevalence (45.3% versus 31.4%, aOR, 2.24 [95% CI, 1.97–2.56], P <0.001) but similar awareness and treatment rates as White adults. Hispanic adults have similar hypertension prevalence, but lower awareness (71.1% versus 79.1%, aOR, 0.72 [95% CI, 0.58–0.89], P =0.005) and treatment rates (60.5% versus 67.3%, aOR, 0.78 [95% CI, 0.66–0.94], P =0.010) than White adults. Asian adults have similar hypertension prevalence, lower awareness (72.5% versus 79.1%, aOR, 0.75 [95% CI, 0.58–0.97], P =0.038) but similar treatment rates. Black, Hispanic, and Asian Americans have different vulnerabilities in the hypertension control cascade of prevalence, awareness, treatment, and control. These differences can inform targeted public health efforts to promote health equity and reduce the burden of hypertension in the United States.

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