Racial and Ethnic Differences in Blood Pressure Among US Adults, 1999–2018

Hypertension ◽  
2021 ◽  
Author(s):  
Shakia T. Hardy ◽  
Ligong Chen ◽  
Andrea L. Cherrington ◽  
Nathalie Moise ◽  
Byron C. Jaeger ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Ethnic Differences ◽  
Antihypertensive Medication ◽  
The United States ◽  
Black Adults ◽  
Racial And Ethnic Differences ◽  
Hispanic Adults ◽  
The Mean ◽  
White Adults ◽  
Hispanic White

Racial and ethnic differences in blood pressure (BP), regardless of antihypertensive medication use, contribute to cardiovascular disease disparities. We analyzed systolic BP (SBP) data from US adults in the National Health and Nutrition Examination Survey from 1999 to 2002 through 2015 to 2018 (n=51 743) to determine if racial and ethnicity disparities have changed over time. Among US adults not taking antihypertensive medication, the mean age-adjusted SBP (95% CI), mm Hg, in 1999 to 2002 and 2015 to 2018 was 119.6 (118.7–120.5) and 119.4 (118.7–120.1) for non-Hispanic White adults, 124.7 (123.7–125.7) and 124.9 (123.8–125.9) for non-Hispanic Black adults and 120.4 (118.6–122.2) and 120.4 (119.7–121.2) for Hispanic adults. The mean multivariable-adjusted SBP was 4.1 mm Hg (2.7–5.4) higher in 1999 to 2002 and 3.8 mm Hg (2.6–5.0) higher in 2015 to 2018 among non-Hispanic Black adults compared with non-Hispanic White adults, while there was no evidence of a difference between Hispanic adults and non-Hispanic White adults in 1999 to 2002 (−0.2 mm Hg [95% CI, −1.9 to 1.5]) or 2015 to 2018 (−0.8 mm Hg [95% CI, −1.8 to 0.1]). Among US adults taking antihypertensive medication, the mean age-adjusted SBP (95% CI), mm Hg, in 1999 to 2002 and 2015 to 2018 was 129.6 (126.7–132.4) and 127.1 (125.6–128.6) for non-Hispanic White adults, 136.9 (133.8–140.0) and 135.3 (132.5–138.1) for non-Hispanic Black adults and 133.9 (128.0–139.7) and 131.8 (127.6–136.0) for Hispanic adults. After multivariable adjustment, in 1999 to 2002 and 2015 to 2018, mean SBP was 4.8 mm Hg (1.8–7.8) and 6.5 mm Hg (4.5–8.4) higher, respectively, among non-Hispanic Black adults versus White adults, and 2.4 mm Hg (−2.6 to 7.3) and 3.6 mm Hg (0.8 to 6.4) higher, respectively, among Hispanic adults versus non-Hispanic White adults. In the United States, non-Hispanic Black adults continue to have higher SBP levels compared with non-Hispanic White adults.

scholarly journals Hepatocellular Carcinoma and Associated Clinical Features in Latino and Caucasian Patients from a Single Center

2018 ◽  
Vol 17 (5) ◽  
pp. 0-10
Author(s):  
Gabriela N. Kuftinec ◽  
Robert Levy ◽  
Dorothy A. Kieffer ◽  
Valentina Medici
Keyword(s):  
Hepatocellular Carcinoma ◽  
Clinical Features ◽  
Ethnic Differences ◽  
The United States ◽  
Racial And Ethnic Differences ◽  
The Past ◽  
Common Etiology ◽  
Caucasian Patients ◽  
Male Patients ◽  
The Mean

Introduction and aim. Hepatocellular carcinoma (HCC) is the most common type of liver cancer in adults and has seen a rapid increase in incidence in the United States. Racial and ethnic differences in HCC incidence have been observed, with Latinos showing the greatest increase over the past four decades, highlighting a concerning health disparity. The goal of the present study was to compare the clinical features at the time of diagnosis of HCC in Latino and Caucasian patients. Material and methods. We retrospectively screened a total of 556 charts of Latino and Caucasian patients with HCC. Results. The mean age of HCC diagnosis was not significantly different between Latinos and Caucasians, but Latinos presented with higher body mass index (BMI). Rates of hypertension, diabetes, and hyperlipidemia were similar in the two groups. The most common etiology of liver disease was alcohol drinking in Latinos, and chronic hepatitis C in Caucasian patients. Non-Alcoholic Steatohepatitis (NASH) was the associated diagnosis in 8.6% of Latinos and 4.7% of Caucasians. Interestingly, alpha-fetoprotein (AFP) levels at time of diagnosis were higher in Latino patients compared to Caucasians, but this difference was evident only in male patients. Multifocal HCC was slightly more frequent in Latinos, but the two groups had similar cancerous vascular invasion. Latino patients also presented with higher rates of both ascites and hepatic encephalopathy. Conclusion. Latino and Caucasian patients with HCC present with a different profile of etiologies, but cancer features appear to be more severe in Latinos.

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

scholarly journals Is the Association of Diabetes With Uncontrolled Blood Pressure Stronger in Mexican Americans and Blacks Than in Whites Among Diagnosed Hypertensive Patients?

2013 ◽  
Vol 26 (11) ◽  
pp. 1328-1334 ◽  
Author(s):  
Xuefeng Liu ◽  
Ping Song
Keyword(s):  
Blood Pressure ◽  
Racial Differences ◽  
Mexican Americans ◽  
The United States ◽  
Linear Regression Models ◽  
Uncontrolled Blood Pressure ◽  
Hypertensive Patients ◽  
Health And Nutrition ◽  
Multistage Design ◽  
Hispanic White

Abstract BACKGROUND Clinical evidence shows that diabetes may provoke uncontrolled blood pressure (BP) in hypertensive patients. However, racial differences in the associations of diabetes with uncontrolled BP outcomes among diagnosed hypertensive patients have not been evaluated. METHODS A total of 6,134 diagnosed hypertensive subjects aged ≥20 years were collected from the National Health and Nutrition Examination Survey 1999–2008 with a stratified multistage design. Odds ratios (ORs) and relative ORs of uncontrolled BP and effect differences in continuous BP for diabetes over race/ethnicity were derived using weighted logistic regression and linear regression models. RESULTS Compared with participants who did not have diabetes, non-Hispanic black participants with diabetes had a 138% higher chance of having uncontrolled BP, Mexican participants with diabetes had a 60% higher chance of having uncontrolled BP, and non-Hispanic white participants with diabetes had a 161% higher chances of having uncontrolled BP. The association of diabetes with uncontrolled BP was lower in Mexican Americans than in non-Hispanic blacks and whites (Mexican Americans vs. non-Hispanic blacks: relative OR = 0.55, 95% confidence interval (CI) = 0.37–0.82; Mexican Americans vs. non-Hispanic whites: relative OR = 0.53, 95% CI = 0.35–0.80) and the association of diabetes with isolated uncontrolled systolic BP was lower in Mexican Americans than in non-Hispanic whites (Mexican Americans vs. non-Hispanic whites: relative OR = 0.62, 95% CI = 0.40–0.96). Mexican Americans have a stronger associaton of diabetes with decreased systolic BP and diastolic BP than non-Hispanic whites, and a stronger association of diabetes with decreased diastolic BP than non-Hispanic blacks. CONCLUSIONS The association of diabetes with uncontrolled BP outcomes is lower despite higher prevalence of diabetes in Mexican Americans than in non-Hispanic whites. The stronger association of diabetes with BP outcomes in whites should be of clinical concern, considering they account for the majority of the hypertensive population in the United States.

scholarly journals Measuring and explaining racial and ethnic differences in willingness to donate live kidneys in the United States

2013 ◽  
pp. n/a-n/a ◽  
Author(s):  
Tanjala S. Purnell ◽  
Neil R. Powe ◽  
Misty U. Troll ◽  
Nae-Yuh Wang ◽  
Carlton Haywood ◽  
...  
Keyword(s):  
United States ◽  
Ethnic Differences ◽  
The United States ◽  
Racial And Ethnic Differences ◽  
Willingness To Donate

Racial/ethnic differences in knowledge and attitudes towards clinical trials among adults in the United States: An analysis of the 2020 U.S. HINTS.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18573-e18573
Author(s):  
Jessica Yasmine Islam ◽  
Denise Christina Vidot ◽  
Imran K Islam ◽  
Argelis Rivera ◽  
Marlene Camacho-Rivera
Keyword(s):  
Health Care ◽  
Clinical Trial ◽  
Clinical Trials ◽  
Cancer Survivors ◽  
Ethnic Differences ◽  
Black Adults ◽  
Cancer History ◽  
Knowledge And Attitudes ◽  
White Adults ◽  
Racial Ethnic

e18573 Background: Despite the use of clinical trials to provide gold-standard evidence of treatment and intervention effectiveness, racial/ethnic minorities are frequently underrepresented participants. Our objective was to evaluate racial/ethnic differences in knowledge and attitudes towards clinical trials among adults in the U.S. Methods: We leveraged Health Informational National Trends Survey (HINTS) data, which is a weighted, nationally representative survey of 3865 adults (≥18 years). Data were collected between February-June 2020, and included age, race/ethnicity, sex, cancer history, and comorbidities. Participants were asked questions focused on clinical trials, including their knowledge, influential factors to participate, trusted sources of information, and if they were ever invited or participated in a clinical trial. Among adults who self-reported to have heard of clinical trials (n = 2366), we used multivariable logistic regression to evaluate racial/ethnic differences in self-reported invitation and participation in clinical trials after adjustment for cancer history, age, sex, comorbidities, and insurance status. Results: Overall, the sample included 64% non-Hispanic (NH) White, 11% NH-Black, 17% Hispanic, and 5% NH-Asian respondents. Nine percent were cancer survivors. Almost 60% self-reported to at least have some knowledge about clinical trials. When asked about factors that would influence their decision to participate in clinical trials “A lot”, participants across racial groups most frequently chose “I would want to get better” and “If the standard care was not covered by my insurance.” Cancer survivors also frequently reported their decision would be influenced “A lot” or “Somewhat” if “My doctor encouraged me to participate.” NH-White (76%), NH-Black (78%), and Hispanic (77%) cancer survivors reported their trusted source of information about clinical trials was their health care provider; NH-Asian cancer survivors reported their health care provider (51%) as well as government health agencies (30%). Compared to NH-White adults, NH-Black adults were more likely to be invited to participate in a clinical trial (OR: 2.60, 95% CI: 1.53-4.43). However, compared to NH-White adults, our data suggest NH-Black adults were less likely to participate in the clinical trial (OR: 0.76, 95% CI: 0.39-1.49) although not statistically significant. Compared to NH-White adults, NH-Asian adults were less likely to participate in clinical trials (OR: 0.10, 95% CI: 0.06-0.18). Conclusions: Health care providers are a trusted source of clinical trial information. Although NH-Black adults are more likely to be invited, they are less likely to participate in a clinical trial; as well as Asian adults. Efforts to leverage insights gained on factors of influence and sources of trusted information on clinical trials should be prioritized.

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 and ethnic differences in genetic counseling experiences and outcomes in the United States: A systematic review

2020 ◽  
Vol 29 (2) ◽  
pp. 147-165
Author(s):  
Sabrina V. Southwick ◽  
Riley Esch ◽  
Rachel Gasser ◽  
Deborah Cragun ◽  
Krista Redlinger‐Grosse ◽  
...  
Keyword(s):  
United States ◽  
Systematic Review ◽  
Genetic Counseling ◽  
Ethnic Differences ◽  
The United States ◽  
Racial And Ethnic Differences

scholarly journals Lead Exposure and Cardiovascular Disease among Young and Middle-Aged Adults

2019 ◽  
Vol 7 (11) ◽  
pp. 103 ◽  
Author(s):  
Emmanuel Obeng-Gyasi
Keyword(s):  
Blood Pressure ◽  
Logistic Regression ◽  
Lead Exposure ◽  
Binary Logistic Regression ◽  
The United States ◽  
Gamma Glutamyl Transferase ◽  
Middle Aged ◽  
The Mean ◽  
Glutamyl Transferase ◽  
Middle Aged Adults

Lead and its effects on cardiovascular-related markers were explored in this cross-sectional study of young adults (18–44 years) and middle-aged adults (45–65 years) from the United States using the National Health and Nutrition Examination Survey (NHANES), 2009–2016. Degrees of exposure were created using blood lead level (BLL) as the biomarker of exposure based on the epidemiologically relevant threshold of BLL > 5 μg/dL. The mean values, in addition to the percentages of people represented for the markers of interest (systolic blood pressure [SBP], diastolic blood pressure [DBP], gamma-glutamyl transferase [GGT], non-high-density lipoprotein cholesterol [non-HDL-C]) were explored. Among those exposed to lead, the likelihood of elevated clinical markers (as defined by clinically relevant thresholds of above normal) were examined using binary logistic regression. In exploring exposure at the 5 μg/dL levels, there were significant differences in all the mean variables of interest between young and middle-aged adults. The binary logistic regression showed young and middle-aged adults exposed to lead were significantly more likely to have elevated markers (apart from DBP). In all, lead affects cardiovascular-related markers in young and middle-aged U.S. adults and thus we must continue to monitor lead exposure to promote health.

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