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

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

Ethnicity and hypertension

ESC CardioMed ◽  
2018 ◽  
pp. 2895-2898
Author(s):  
Bert-Jan van den Born ◽  
Charles Agyemang
Keyword(s):  
United States ◽  
Blood Pressure ◽  
Calcium Channel ◽  
Ethnic Differences ◽  
European Society ◽  
The United States ◽  
Hypertension Prevalence ◽  
Blocking Agents ◽  
Pressure Lowering ◽  
And Control

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.

scholarly journals Racial/Ethnic Differences in Physician Distrust in the United States

2007 ◽  
Vol 97 (7) ◽  
pp. 1283-1289 ◽  
Author(s):  
Katrina Armstrong ◽  
Karima L. Ravenell ◽  
Suzanne McMurphy ◽  
Mary Putt
Keyword(s):  
United States ◽  
Ethnic Differences ◽  
The United States ◽  
Racial Ethnic

scholarly journals Hypertension Control in the United States 2009 to 2018: Factors Underlying Falling Control Rates During 2015 to 2018 Across Age- and Race-Ethnicity Groups

Hypertension ◽  
2021 ◽  
Author(s):  
Brent M. Egan ◽  
Jiexiang Li ◽  
Susan E. Sutherland ◽  
Michael K. Rakotz ◽  
Gregory D. Wozniak
Keyword(s):  
United States ◽  
Blood Pressure ◽  
Health Care ◽  
Access To Care ◽  
Odds Ratio ◽  
Treatment Effectiveness ◽  
The United States ◽  
Hypertension Control ◽  
Race Ethnicity ◽  
Hispanic White

Hypertension control (United States) increased from 1999 to 2000 to 2009 to 2010, plateaued during 2009 to 2014, then fell during 2015 to 2018. We sought explanatory factors for declining hypertension control and assessed whether specific age (18–39, 40–59, ≥60 years) or race-ethnicity groups (Non-Hispanic White, NH [B]lack, Hispanic) were disproportionately impacted. Adults with hypertension in National Health and Nutrition Examination Surveys during the plateau (2009–2014) and decline (2015–2018) in hypertension control were studied. Definitions: hypertension, blood pressure (mm Hg) ≥140 and/or ≥90 mm Hg or self-reported antihypertensive medications (Treated); Aware, ‘Yes” to, “Have you been told you have hypertension?”; Treatment effectiveness, proportion of treated adults controlled; control, blood pressure <140/<90. Comparing 2009 to 2014 to 2015 to 2018, blood pressure control fell among all adults (−7.5% absolute, P <0.001). Hypertension awareness (−3.4%, P =0.01), treatment (−4.6%, P =0.004), and treatment effectiveness (−6.0%, P <0.0001) fell, despite unchanged access to care (health care insurance, source, and visits [−0.2%, P =0.97]). Antihypertensive monotherapy rose (+4.2%, P =0.04), although treatment resistance factors increased (obesity +4.0%, P =0.02, diabetes +2.3%, P =0.02). Hypertension control fell across age (18–39 [−4.9%, P =0.30]; 40–59 [−9.9%, P =0.0003]; ≥60 years [−6.5%, P =0.005]) and race-ethnicity groups (Non-Hispanic White [−8.5%, P =0.0007]; NHB −7.4%, P =0.002]; Hispanic [−5.2%, P =0.06]). Racial/ethnic disparities in hypertension control versus Non-Hispanic White were attenuated after adjusting for modifiable factors including education, obesity and access to care; NHB (odds ratio, 0.79 unadjusted versus 0.84 adjusted); Hispanic (odds ratio 0.74 unadjusted versus 0.98 adjusted). Improving hypertension control and reducing disparities require greater and more equitable access to high quality health care and healthier lifestyles.

scholarly journals Trends in Cigar Use in the United States, 2002–2016: Diverging Trends by Race/Ethnicity

2019 ◽  
Vol 22 (4) ◽  
pp. 583-587 ◽  
Author(s):  
Andrea H Weinberger ◽  
Cristine D Delnevo ◽  
Jiaqi Zhu ◽  
Misato Gbedemah ◽  
Joun Lee ◽  
...  
Keyword(s):  
United States ◽  
Black Women ◽  
Ethnic Group ◽  
Ethnic Groups ◽  
Ethnic Differences ◽  
Mixed Race ◽  
The United States ◽  
Race Ethnicity ◽  
Racial Ethnic ◽  
Over Time

Abstract Introduction Although there are racial/ethnic differences in cigarette use, little is known about how non-cigarette tobacco use differs among racial/ethnic groups. This study investigated trends in cigar use from 2002 to 2016, by racial/ethnic group, in nationally representative US data. Methods Data were drawn from the 2002–2016 National Survey on Drug Use and Health public use data files (total analytic sample n = 630 547 including 54 060 past-month cigar users). Linear time trends of past-month cigar use were examined by racial/ethnic group (Non-Hispanic [NH] White, NH Black, Hispanic, NH Other/Mixed Race/Ethnicity) using logistic regression models. Results In 2016, the prevalence of past-month cigar use was significantly higher among NH Black respondents than among other racial/ethnic groups (ps &lt; .001). Cigar use was also higher among NH White respondents than among Hispanic and NH Other/Mixed Race/Ethnicity respondents. The year by racial/ethnic group interaction was significant (p &lt; .001). Past-month cigar use decreased significantly from 2002 to 2016 among NH White and Hispanic respondents (ps = .001), whereas no change in prevalence was observed among NH Black (p = .779) and NH Other/Mixed Race/Ethnicity respondents (p = .152). Cigar use decreased for NH White men (p &lt; .001) and did not change for NH White women (p = .884). Conversely, cigar use increased for NH Black women (p &lt; .001) and did not change for NH Black men (p = .546). Conclusions Cigar use remains significantly more common among NH Black individuals in the United States and is not declining among NH Black and NH Other/Mixed Race/Ethnicity individuals over time, in contrast to declines among NH White and Hispanic individuals. Implications This study identified racial/ethnic differences in trends in past-month cigar use over 15 years among annual cross-sectional samples of US individuals. The highest prevalence of cigar use in 2016 was found among NH Black individuals. In addition, cigar use prevalence did not decline from 2002 to 2016 among NH Black and NH Other/Mixed Race/Ethnicity groups over time, in contrast to NH White and Hispanic groups. Further, cigar use increased over time for NH Black women. Targeted public health and clinical efforts may be needed to decrease the prevalence of cigar use, especially for NH Black individuals.

Geography, Race/Ethnicity, and Obesity Among Men in the United States

2015 ◽  
Vol 10 (3) ◽  
pp. 228-236 ◽  
Author(s):  
Elizabeth A. Kelley ◽  
Janice V. Bowie ◽  
Derek M. Griffith ◽  
Marino Bruce ◽  
Sarah Hill ◽  
...  
Keyword(s):  
United States ◽  
Ethnic Differences ◽  
White Men ◽  
The United States ◽  
Geographic Region ◽  
The South ◽  
Lower Odds ◽  
Logistic Regression Models ◽  
Geographic Regions ◽  
Racial Ethnic

The prevalence of obesity in the United States has increased significantly and is a particular concern for minority men. Studies focused at the community and national levels have reported that geography can play a substantial role in contributing to obesity, but little is known about how regional influences contribute to obesity among men. The objective of this study is to examine the association between geographic region and obesity among men in the United States and to determine if there are racial/ethnic differences in obesity within these geographic regions. Data from men, aged 18 years and older, from the National Health Interview Survey were combined for the years 2000 to 2010. Obesity was defined as body mass index (BMI) ≥30 kg/m2. Logistic regression models were specified to calculate the odds ratio (OR) and 95% confidence interval (CI) for the association between geographic region and obesity and for race and obesity within geographic regions. Compared to men living in the Northeast, men living in the Midwest had significantly greater odds of being obese (OR = 1.09, 95% CI [1.02, 1.17]), and men living in the West had lower odds of being obese (OR = 0.82, 95% CI [0.76, 0.89]). Racial/ethnic differences were also observed within geographic region. Black men have greater odds of obesity than White men in the South, West, and Midwest. In the South and West, Hispanic men also have greater odds of obesity than White men. In all regions, Asian men have lower odds of obesity than White men.

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