Environmental, societal, and genetic contributions to the epidemic of hypertension in African Americans

Nesbitt, Shawna D.

doi:10.1007/s12170-008-0034-z

Cited by 2 publications

(6 citation statements)

References 44 publications

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“…There is a persistent difference in the BP control rates comparatively between non‐blacks and blacks. This may be due to the difference in the underlying pathophysiology of the RAS and autonomic nervous system between non‐blacks and blacks . However, the control rates achieved in this study exceed those reported for black patients in the National Health and Nutrition Examination Survey (ie, 42.7% of treated blacks) .…”

Section: Discussioncontrasting

confidence: 72%

“…This may be due to the difference in the underlying pathophysiology of the RAS and autonomic nervous system between non-blacks and blacks. 13 However, the control rates achieved in this study exceed those reported for black patients in the National Health and Nutrition Examination Survey (ie, 42.7% of treated blacks). 20 The strong relationship between BP control and a reduction in CVD in all populations suggests the potential for improved CVD outcomes in blacks.…”

Section: Discussioncontrasting

confidence: 71%

“…A number of factors likely influence decreased BP control among blacks . These factors include a poorer quality of diet intake, higher rates of overweight/obesity, lower physical inactivity, higher psychosocial stress, poorer access to healthcare, and an increased prevalence of some gene polymorphisms . Among the physiologic factors that contribute to the disparity in hypertension in blacks is the increased ratio of sodium to potassium intake, due to excess sodium intake and/or an inadequate potassium intake, as well as a modest increase in sodium sensitivity.…”

Section: Discussionmentioning

confidence: 99%

“…1,12 These factors include a poorer quality of diet intake, higher rates of overweight/ obesity, lower physical inactivity, higher psychosocial stress, poorer access to healthcare, and an increased prevalence of some gene polymorphisms. 13,14 Among the physiologic factors that contribute to the disparity in hypertension in blacks is the increased ratio of sodium to potassium intake, due to excess sodium intake and/or an inadequate potassium intake, as well as a modest increase in sodium sensitivity. Nonetheless, there are many physiologic factors such as increased a-receptor sensitivity, decreased b-receptor sensitivity, increased endothelin, and a relative reduction in nitric oxide/ reactive oxide species ratio.…”

Section: Discussionmentioning

confidence: 99%

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Efficacy/Safety of a Fixed‐Dose Amlodipine/Olmesartan Medoxomil–Based Treatment Regimen in Hypertensive Blacks and Non‐Blacks With Uncontrolled BP on Prior Antihypertensive Monotherapy

Nesbitt

Shojaee

Maa

2013

J of Clinical Hypertension

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In this secondary analysis of a dose-titration study of patients with hypertension uncontrolled on prior monotherapy, blacks (n=234) and non-blacks (n=765) were switched to amlodipine (AML)/olmesartan medoxomil (OM) 5/20 mg, with uptitration every 4 weeks to AML/OM 5/40 mg and then AML/OM 10/40 mg to achieve a seated cuff blood pressure (SeBP) of <120/70 mm Hg. Hydrochlorothiazide 12.5 and 25 mg could be added if SeBP was ! 125/75 mm Hg. The cumulative proportions of patients achieving systolic SeBP <140 mm Hg (<130 mm Hg if diabetic) at 12 weeks were 71.6% for blacks and 77.2% for non-blacks. Mean SeBP change from baseline in blacks (mean baseline BP: 153.0/ 93.7 mm Hg) ranged from À11.7/À6.1 mm Hg for AML/OM 5/20 mg to À23.6/À12.9 mm Hg for AML/OM 10/40 mg +hydrochlorothiazide 25 mg (all P<.0001). Antihypertensive efficacy was maintained throughout the 24-hour dosing interval. An AML/OM-based regimen was effective in blacks with hypertension uncontrolled on prior monotherapy. J Clin Hypertens (Greenwich) 2013;15:247-253. ª2013 Wiley Periodicals, Inc.

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Section: Discussioncontrasting

confidence: 72%

Section: Discussioncontrasting

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Efficacy/Safety of a Fixed‐Dose Amlodipine/Olmesartan Medoxomil–Based Treatment Regimen in Hypertensive Blacks and Non‐Blacks With Uncontrolled BP on Prior Antihypertensive Monotherapy

Nesbitt

Shojaee

Maa

2013

J of Clinical Hypertension

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“…In 2017, the World Health Organization (WHO) reported that CVD is “the number one cause of death globally” [ 5 ]. This emerging CVD epidemic in resource-poor settings is likely due to an increase in traditional CVD risk factors, such as smoking, hypertension (HTN), and diabetes, as well as other social and environmental determinants such as poverty, stress, social isolation, depression, the effect of food insecurity on dietary habits, and environmental lead exposure [ 6 – 10 ]. With CVD being the largest driver of global mortality, the WHO has ambitiously targeted a one-third reduction in premature deaths from CVD and other non-communicable diseases by 2025 [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

The Haiti cardiovascular disease cohort: study protocol for a population-based longitudinal cohort

Lookens¹,

Tymejczyk²,

Rouzier³

et al. 2020

BMC Public Health

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Background Cardiovascular disease (CVD) is the leading cause of mortality among Haitians, having surpassed HIV in the last decade. Understanding the natural history of CVD in Haitians, including the age of onset, prevalence, incidence, and role of major risk factors and social determinants, is urgently needed to develop prevention and treatment interventions. Aim 1: Establish a population-based cohort of 3000 adults from Port-au-Prince and assess the prevalence of CVD risk factors and diseases and their association with social and environmental determinants. Aim 2: Determine the incidence of CVD risk factors and CVD during 2–3.5 years of follow-up and their association with social and environmental determinants. Methods The Haiti CVD Cohort is a longitudinal observational study of 3000 adults > 18 years in Port-au-Prince (PAP), Haiti. The study population is recruited using multistage random sampling from census blocks. Adults receive blood pressure (BP) measurements in the community and those with elevated BP are referred to the Groupe Haitien d’Etude Sarcome de Kaposi et des Infections Opportunistes Clinic for care. After informed consent, participants undergo a clinical exam with medical history. BP, electrocardiogram, echocardiogram, a study questionnaire on health behaviors, and laboratory specimens. Every 6 months, BP is remeasured. At 12 and 24 months, clinical exams and questionnaires are repeated. Labs are repeated at 24 months. Adjudicated study outcomes include the prevalence and incidence of CVD risk factors (hypertension, diabetes, obesity, dyslipidemia, kidney disease, inflammation, poor diet, smoking, and physical inactivity) and events (myocardial infarction, heart failure, stroke, and CVD mortality). We also measure social determinants including poverty. Depression, stress, social isolation, food insecurity, and lead exposure. Blood, urine, and stool samples are biobanked at study enrollment. Discussion The Haiti CVD Cohort is the largest population-based cohort study evaluating CVD risk factors and CVD among adults in urban Haiti with the goal of understanding the drivers of the CVD epidemic in Haiti. Study outcomes are comparable with existing international cohorts, and the biobank will provide important data for future research. Our goal is to translate findings from this study into pragmatic prevention and treatment interventions to fight the CVD epidemic in Haiti.

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Environmental, societal, and genetic contributions to the epidemic of hypertension in African Americans

Cited by 2 publications

References 44 publications

Efficacy/Safety of a Fixed‐Dose Amlodipine/Olmesartan Medoxomil–Based Treatment Regimen in Hypertensive Blacks and Non‐Blacks With Uncontrolled BP on Prior Antihypertensive Monotherapy

Efficacy/Safety of a Fixed‐Dose Amlodipine/Olmesartan Medoxomil–Based Treatment Regimen in Hypertensive Blacks and Non‐Blacks With Uncontrolled BP on Prior Antihypertensive Monotherapy

The Haiti cardiovascular disease cohort: study protocol for a population-based longitudinal cohort

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