Baseline characteristics of African Americans in the Systolic Blood Pressure Intervention Trial

Still, Carolyn H; Craven, Timothy E.; Freedman, Barry I.; Buren, Peter Noel Van; Sink, Kaycee M.; Killeen, Anthony A.; Bates, Jeffrey T.; Bee, Alberta; Contreras, Gabriel; Oparil, Suzanne; Pedley, Carolyn M.; Wall, Barry M.; White, Suzanne; Woods, Delia M.; Rodríguez, Carlos J.; Wright, Jackson T.

doi:10.1016/j.jash.2015.06.012

Cited by 14 publications

(10 citation statements)

References 28 publications

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“…We believe the emphasis on using combination therapy will result in most participants being on ACEIs/ARBs as part of their regimen. At baseline, the frequency of ACEI/ARB use was similar in blacks and non-blacks 33 . These modern day trials tend to emphasize combination therapy even in relatively low risk patients 34 .…”

Section: Discussionmentioning

confidence: 89%

Hypertension Treatment in Blacks: Discussion of the U.S. Clinical Practice Guidelines

Williams

Ravenell

Seyedali

et al. 2016

Progress in Cardiovascular Diseases

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Blacks are especially susceptible to hypertension(HTN) and its associated organ damage leading to adverse cardiovascular, cerebrovascular and renal outcomes. Accordingly, HTN is particularly significant in contributing to the black-white racial differences in health outcomes in the US. As such, in order to address these health disparities, practical clinical practice guidelines (CPGs) on how to treat HTN, specifically in blacks, are needed. This review article is a timely addition to the literature because the most recent U.S. CPG more explicitly emphasizes race into the algorithmic management of HTN. However, recent clinical research cautions that use of race as a proxy to determine therapeutic response to pharmaceutical agents may be erroneous. This review will address the implications of the use of race in the hypertension CPGs. We will review the rationale behind the introduction of race into the U.S. CPG and the level of evidence that was available to justify this introduction. Finally, we will conclude with practical considerations in the treatment of HTN in blacks.

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Section: Discussionmentioning

confidence: 89%

Hypertension Treatment in Blacks: Discussion of the U.S. Clinical Practice Guidelines

Williams

Ravenell

Seyedali

et al. 2016

Progress in Cardiovascular Diseases

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“…Clinic selection issues in PR probably accounted for some of these differences. Characteristics of non‐Hispanic blacks in SPRINT have been previously reported . Compared with non‐Hispanic blacks, Hispanics in SPRINT were taking fewer BP medications at enrollment and were less likely to be smokers but were as likely to have less than a high school education or be uninsured.…”

Section: Discussionmentioning

confidence: 99%

Baseline blood pressure control in Hispanics: characteristics of Hispanics in the Systolic Blood Pressure Intervention Trial

Rodríguez

Still

Garcia

et al. 2016

J of Clinical Hypertension

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The Systolic Blood Pressure Intervention Trial tested whether a systolic blood pressure (SBP) < 120 mmHg reduces adverse clinical outcomes compared to the goal of < 140 mmHg. Here we describe the baseline characteristics of Hispanic participants in SPRINT. Non-diabetic hypertensive patients who are ≥50 years old with SBP 130-180 mmHg on 0-4 BP medications were enrolled in the mainland US and Puerto Rico (PR). Cross-sectional, bivariate analysis was employed comparing sociodemographic and clinical factors in Hispanics vs. non-Hispanics. Multivariable logistic regression models restricted to Hispanics were used to identify factors associated with achieved BP control (SBP < 140 mmHg and diastolic BP < 90 mmHg) at baseline. Eleven percent (n=984) of SPRINT participants were Hispanic; 56% (n=549) of Hispanics were living in PR, the remainder were living on the US mainland. Hispanics overall were younger, female, less likely to live alone, more likely to have lower education and be uninsured, although just as likely to be employed compared to non-Hispanics. BP control was not different between Hispanics vs. non-Hispanics at baseline. However, a significantly higher percentage of Hispanics on the US Mainland (compared to Hispanics in PR) were BP controlled. BP control was independently associated with cardiovascular disease history and functional status among Hispanics, specifically those living in PR. Whereas functional status was the only independent predictor of BP control s identified among mainland Hispanics. These findings highlight the diversity of the SPRINT population. It remains to be seen whether factors identified among Hispanics impact intervention goals and subsequent clinical outcomes.

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“…This observation may indicate the need for careful consideration of changes to the definition of prehypertension in the case of adolescent. The fact that the BP of Congolese children of Lubumbashi is so high at the beginning of adolescence, could be justified by several observations showing that hypertension in black subjects occurs at the early age [25, 26]. In addition, the 90th BP percentile for adolescents aged 17 years (in both sexes) was 130 mmHg, which is equal to the recommended optimal SBP for adult to define metabolic syndrome [27].…”

Section: Discussionmentioning

confidence: 99%

Oscillometric blood pressure by age and height for non overweight children and adolescents in Lubumbashi, Democratic Republic of Congo

Muyumba

Nkulu

Mukeng

et al. 2018

BMC Cardiovasc Disord

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BackgroundThe diagnosis of hypertension in children is complex because based on normative values by sex, age and height, and these values vary depending on the environment. Available BP references used, because of the absence of local data, do not correspond to our pediatric population. Accordingly, our study aimed to provide the BP threshold for children and adolescents in Lubumbashi (DRC) and to compare them with German (KIGGS study), Polish (OLAF study) and Chinese (CHNS study) references.MethodsWe conducted a cross-sectional study among 7523 school-children aged 3 to 17 years. The standardized BP measurements were obtained using a validated oscillometric device (Datascope Accutor Plus). After excluding overweight and obese subjects according to the IOTF definition (n = 640), gender-specific SBP and DBP percentiles, which simultaneously accounted for age and height by using an extension of the LMS method, namely GAMLSS, were tabulated.ResultsThe 50th, 90th and 95th percentiles of SBP and DBP for 3373 boys and 3510 girls were tabulated simultaneously by age and height (5th, 25th, 50th, 75th and 95th height percentile).Before 13 years the 50th and 90th percentiles of SBP for boys were higher compared with those of KIGGS and OLAF, and after they became lower: the difference for adolescents aged 17 years was respectively 8 mmHg (KIGGS) and 4 mmHg (OLAF). Concerning girls, the SBP 50th percentile was close to that of OLAF and KIGGS studies with differences that did not exceed 3 mmHg; whereas the 90th percentile of girls at different ages was high. Our oscillometric 50th and 90th percentiles of SBP and DBP were very high compared to referential ausculatory percentiles of the CHNS study respectively for boys from 8 to 14 mmHg and 7 to 13 mmHg; and for girls from 10 to 16 mmHg and 11 to 16 mmHg.ConclusionsThe proposed BP thresholds percentiles enable early detection and treatment of children and adolescents with high BP and develop a local program of health promotion in schools and family.Electronic supplementary materialThe online version of this article (10.1186/s12872-018-0741-4) contains supplementary material, which is available to authorized users.

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Baseline characteristics of African Americans in the Systolic Blood Pressure Intervention Trial

Cited by 14 publications

References 28 publications

Hypertension Treatment in Blacks: Discussion of the U.S. Clinical Practice Guidelines

Hypertension Treatment in Blacks: Discussion of the U.S. Clinical Practice Guidelines

Baseline blood pressure control in Hispanics: characteristics of Hispanics in the Systolic Blood Pressure Intervention Trial

Oscillometric blood pressure by age and height for non overweight children and adolescents in Lubumbashi, Democratic Republic of Congo

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