Epidemiology of Hypertension and Cardiovascular Disease in African Americans

Abstract

Hypertension is a major cause of cardiovascular-renal morbidity and mortality and all-cause mortality. It is a highly significant problem for African Americans; about 30% of all deaths in this population are attributable to hypertension. Compared with whites, hypertension in African Americans is more prevalent, occurs earlier in life, is more severe, and is more often associated with target organ injury such as left ventricular hypertrophy and other cardiovascular complications. Only 25% of all African Americans with hypertension and fewer than 50% of those receiving drug treatment attain a blood pressure <140/90 mm Hg. These control rates are somewhat less than in white Americans. Enhanced awareness and understanding of the epidemiologic patterns of hypertension, other cardiovascular risk factors, risk-factor control rates, and factors influencing these control rates should lead to better approaches to risk-factor control. This most likely would result in a reduction of cardiovascular disease complications.

Efficacy and safety of initial combination therapy with amlodipine/valsartan compared with amlodipine monotherapy in black patients with stage 2 hypertension: the EX-STAND study

“…23 Black hypertensives have B8-fold greater prevalence (8.5 vs o1%) of severe hypertension (4180/ 110 mm Hg compared to white individuals with hypertension. 24 Thus, we examined the impact of our two treatment strategies in participants with severe baseline SBP elevations (X180 mm Hg). In this subgroup least square mean change from baseline in MSSBP at week 12 was 50.5 (4.3) mm Hg (with the elective addition of HCTZ 12.5 mg) compared with a decrease of 41.7 (3.8) mm Hg in the amlodipine/HCTZ group (P ¼ 0.0465).…”

The role of stress and social support in predicting depression among a hypertensive African American sample

“…Studies suggest that this population experiences a risk for developing hypertension that is two to three times higher than experienced by Caucasians (10,11). Furthermore, in the United States, African American women between the ages of 25 and 34 have the highest incidence of hypertension (12), and by the age of 25, both African American men and women have a hypertension prevalence rate that is more than twice as high as similarly aged Caucasian men and women (1).…”

Smoking Behavior Among Low-Income Black Adults: Patterns and Correlates of Smoking Trajectories

“…Despite the similarities in smoking rates, Blacks are disproportionally affected by smoking-related causes of death, such as cancer and cardiovascular disease (Flack, Ferdinand, & Nasser, 2003;Harper, Lynch, Burris, & Davey Smith, 2007;Kung, Hoyert, Xu, & Murphy, 2008). The disparities in smoking-related deaths might reflect smoking topography (e.g., deeper inhalation or a preference for mentholated cigarettes that may facilitate the absorption of harmful toxins; Muscat, Richie, & Stellman, 2002;Perez-Stable, Herrera, Jacob, & Benowitz, 1998; U.S. Department of Health and Human Services, 1998) as well as less access to early diagnosis and treatment of smoking-related diseases (DeLancey, Thun, Jemal, & Ward, 2008).…”