Background and aims Hypertension is an important global health burden with major differences in prevalence among ethnic minorities compared to host populations. Longitudinal research on ethnic differences in blood pressure (BP) levels provides the opportunity to assess the efficacy of strategies aimed at mitigating gaps in hypertension control. In this study we assessed the change in BP levels over time in a multi-ethnic population-based cohort in Amsterdam, the Netherlands. Methods We used baseline and follow-up data from HELIUS to assess differences in BP over time between participants of Dutch, South-Asian Surinamese, African Surinamese, Ghanaian, Moroccan and Turkish descent. Baseline data were collected between 2011-2015, follow-up data between 2019-2021. Main outcome was ethnic differences in systolic BP over time determined by linear mixed models adjusted for age, sex, and use of antihypertensive medication. Results We included 22,109 participants at baseline, from which 10,170 participants had complete follow-up data. Mean follow-up time was 6.3 (1.1) years. Compared to the Dutch population, mean systolic BP increased significantly more from baseline to follow-up in Ghanaians (1.78 mmHg, 95%CI 0.77–2.79), Moroccans (2.06 mmHg, 95%CI 1.23–2.90), and the Turkish population (1.30 mmHg, 95%CI 0.38–2.22). SBP differences were in part explained by differences in BMI. No differences in systolic BP trajectory were present between the Dutch and Surinamese population. Conclusion Our findings indicate a further increase of ethnic differences in systolic BP among Ghanaian, Moroccan, and Turkish populations compared to the Dutch reference population that are in part attributable to differences in BMI.

Objective: Hypertension can be classified into different phenotypes according to systolic and diastolic blood pressure (BP). We assessed the natural course of BP phenotypes over time in younger adults and identified risk factors predisposing to the development of sustained hypertension in a diverse population. Design and method: We used baseline and follow-up data from all participants aged below 40 years without antihypertensive medication at baseline from the ongoing multi-ethnic HEalthy LIFe in an Urban Setting (HELIUS) study. Participants were stratified according to baseline office BP: normotensive (NT; < 140/< 90 mmHg), isolated systolic hypertension (ISH; > = 140/< 90 mmHg), isolated diastolic hypertension (IDH; < 140/> = 90 mmHg) and combined systolic and diastolic hypertension (SDH; > = 140/> = 90 mmHg). Sankey diagrams were created stratified by sex to visualise change in phenotypes over time and risk of sustained hypertension (defined as BP > = 140/90 mmHg or use of antihypertensive medication) was assessed using logistic regression models adjusted for age, sex, ethnicity and follow-up time. In further adjusted models we added BMI, smoking, baseline eGFR, glucose, and total cholesterol levels to assess risk factors. Results: We included 2,818 participants aged 30.1 years (SD 6.0), 44% male, who attended the follow-up visit with a median follow-up time of 6.2 years (SD 1.1). Of all participants, 91.5% was normotensive at baseline, whereas 2.8%, 2.8% and 2.9% had ISH, IDH and SDH, respectively. In males the prevalence of ISH decreased over time, while in females the prevalence increased (figure). Compared to normotensive individuals, the adjusted odds ratios for developing sustained hypertension were 4.5 (95% CI 2.5 – 7.9) for ISH, 17.4 (95% CI 10.7 - 28.4) for IDH and 33.5, (95% CI 19.7 – 58.9) for SDH. Higher BMI was the most important predictor for development of sustained hypertension. Conclusions: Participants with SDH had the highest risk for developing sustained hypertension, followed by participants with IDH. The risk for sustained hypertension in individuals with ISH was much lower and differed between males and females, suggesting differences in pathophysiology and management.

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Background Ethnic health disparities have rarely been explored from a multidimensional ageing perspective. The objective of this study was to investigate these disparities in the Healthy Life in an Urban Setting (HELIUS) cohort using the Healthy Ageing Score (HAS). Methods We computed the HAS using seven biopsychosocial domains from HELIUS baseline data (2011-2015), discerning between healthy, moderate, and poor ageing. We explored HAS differences by ethnicity, sex, and age group using Kruskal Wallis, Pearson Chi-squared, and multinomial logistic regression, adjusting for sociodemographic factors. Results We included 17,091 participants (54.8% women, age (mean (SD)=44.5(12.8) years)) from South-Asian (14.8%) and African (20.5%) Surinamese, Dutch (24.3%), Moroccan (15.5%), Turkish (14.9%), and Ghanaian (10.1%) origins. The HAS (overall: poor (69.0%), moderate (24.8%), and healthy (6.2%)) differed between ethnicities (poorest in South-Asian Surinamese) and was poorer in women and post midlife (cut-off 45 years) across all ethnicities (all p≤0.0001). In the fully-adjusted models in men and women, poor ageing (vs. healthy ageing) was highest in the South-Asian Surinamese (aOR(95%CI)) (2.96(2.24-3.90) and 6.88(3.29-14.40), respectively) and the Turkish (2.80(2.11-3.73) and 7.10(3.31-15.24), respectively) groups compared to the Dutch, in the oldest age group (5.89(3.62-9.60) and 13.17(1.77-98.01), respectively) vs. the youngest, and in the divorced (1.48(1.10-2.01) and 2.83(1.39-5.77), respectively) vs. the married. Poor ageing was inversely associated with educational and occupational levels, mainly in men. Conclusion Ethnic minorities displayed less healthy ageing than theDutch. This disparity appeared to be more pronounced in women, persisted before and after midlife, and was associated with sociodemographic factors that warrant further investigation.