Ethnicity and hypertension

ESC CardioMed ◽  
2018 ◽  
pp. 2895-2898
Author(s):  
Bert-Jan van den Born ◽  
Charles Agyemang
Keyword(s):  
United States ◽  
European Society ◽  
African Descent ◽  
Renin Angiotensin System ◽  
The United States ◽  
Angiotensin System ◽  
Hypertension Prevalence ◽  
Blocking Agents ◽  
Sub Saharan ◽  
And Control

Worldwide, large differences exist in the prevalence of hypertension and hypertension-mediated 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, 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, but data in both Europe and the United States consistently show higher prevalence rates of hypertension and hypertension-mediated 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 physiological traits, in particular salt sensitivity and vascular contractility. While there is little evidence for a different reaction to blood pressure-lowering therapy in other ethnic groups, thiazide diuretics and calcium channel blocking agents are generally more effective in sub-Saharan African descent populations compared with renin–angiotensin system blockers and beta-blocking agents. The 2018 European Society of Hypertension/European Society of Cardiology Guidelines recommend to start withsingle-pill combinationtherapy in most hypertensive patients and to start with thiazide or thiazide-like diuretics and calciumchannel blockers in sub-Saharan African descent populationseithercombined with each other or with a renin–angiotensin system blocker as they make the latter more effective. The observeddisparities in hypertension prevalence and treatment responsesmay also help to increase our understanding of the complex pathophysiology of hypertension and improve strategies aimed at the selection and control of hypertension in the population at large.

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.

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

Hypertension ◽  
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.

scholarly journals Genetics of Hypertension in African Americans and Others of African Descent

2019 ◽  
Vol 20 (5) ◽  
pp. 1081 ◽  
Author(s):  
Mihail Zilbermint ◽  
Fady Hannah-Shmouni ◽  
Constantine Stratakis
Keyword(s):  
United States ◽  
African Americans ◽  
African Descent ◽  
The United States ◽  
Racial Groups ◽  
Angiotensin System ◽  
The Public ◽  
Low Renin Hypertension ◽  
Gated Channel ◽  
G Protein Coupled

Hypertension is the leading cause of cardiovascular disease in the United States, affecting up to one-third of adults. When compared to other ethnic or racial groups in the United States, African Americans and other people of African descent show a higher incidence of hypertension and its related comorbidities; however, the genetics of hypertension in these populations has not been studied adequately. Several genes have been identified to play a role in the genetics of hypertension. They include genes regulating the renin-aldosterone-angiotensin system (RAAS), such as Sodium Channel Epithelial 1 Beta Subunit (SCNN1B), Armadillo Repeat Containing 5 (ARMC5), G Protein-Coupled Receptor Kinase 4 (GRK4), and Calcium Voltage-Gated Channel Subunit Alpha1 D (CACNA1D). In this review, we focus on recent genetic findings available in the public domain for potential differences between African Americans and other populations. We also cover some recent and relevant discoveries in the field of low-renin hypertension from our laboratory at the National Institutes of Health. Understanding the different genetics of hypertension among various groups is essential for effective precision-guided medical therapy of high blood pressure.

scholarly journals Cardiometabolic Health in African Immigrants to the United States: A Call to Re-examine Research on African-descent Populations

2015 ◽  
Vol 25 (3) ◽  
pp. 373 ◽  
Author(s):  
Yvonne Commodore-Mensah, PhD, RN ◽  
Cheryl Dennison Himmelfarb, PhD, ANP, RN ◽  
Charles Agyemang, PhD, MPH ◽  
Anne E. Sumner, MD
Keyword(s):  
United States ◽  
Social Economic ◽  
African Descent ◽  
African Immigrants ◽  
The United States ◽  
Sub Saharan Africa ◽  
Cardiometabolic Health ◽  
Optimal Care ◽  
Black African ◽  
Sub Saharan

<p> </p><p> In the 20th century, Africans in Sub-Saharan Africa had lower rates of cardiometabolic disease than Africans who migrated. How­ever, in the 21st century, beyond infectious diseases, the triple epidemics of obesity, diabetes and hypertension have taken hold in Africa. Therefore, Africans are acquiring these chronic diseases at different rates and different intensity prior to migration. To ensure optimal care and health outcomes, the United States practice of grouping all African-descent populations into the “Black/ African American” category without regard to country of origin masks socioeconomic and cultural differences and needs re-evalu­ation. Overall, research on African-descent populations would benefit from a shift from a racial to an ethnic perspective. To dem­onstrate the value of disaggregating data on African-descent populations, the epide­miologic transition, social, economic, and health characteristics of African immigrants are presented. <em>Ethn Dis. </em>2015;25(3):373- 380.</p>

Effects of renovascular hypertension on rat adrenal zona glomerulosa

1978 ◽  
Vol 36 (2) ◽  
pp. 582-583
Author(s):  
G. Mazzocchi ◽  
P. Rebuffat ◽  
C. Robba ◽  
P. Vassanelli ◽  
G. G. Nussdorfer
Keyword(s):  
Renovascular Hypertension ◽  
Left Kidney ◽  
Renin Angiotensin System ◽  
Plasma Renin ◽  
Zona Glomerulosa ◽  
Ultrastructural Changes ◽  
Albino Rats ◽  
Left Renal Artery ◽  
Angiotensin System ◽  
And Control

It is well known that the rat adrenal zona glomerulosa steroidogenic activity is controlled by the renin-angiotensin system. The ultrastructural changes in the rat zona glomerulosa cells induced by renovascular hypertension were described previously, but as far as we are aware no correlated biochemical and morphometric investigations were performed.Twenty adult male albino rats were divided into 2 experimental groups. One group was subjected to restriction of blood flow to the left kidney by the application of a silver clip about the left renal artery. The other group was sham-operated and served as a control. Renovascular hypertension developed in about 10 days: sistolic blood pressure averaged 165 ± 6. 4 mmHg, whereas it was about 110 ± 3. 8 mmHg in the control animals. The hypertensive and control rats were sacrificed 20 days after the operation. The blood was collected and plasma renin activity was determined by radioimmunological methods. The aldosterone concentration was radioimmunologically assayed both in the plasma and in the homogenate of the left capsular adrenal gland.

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