Hypertension: effects of social class and racial admixture: the results of a cohort study in the black population of Charleston, South Carolina.

Keil, Julian; Tyroler, Herman A.; Sandifer, Samuel H.; E, Boyle

doi:10.2105/ajph.67.7.634

Cited by 97 publications

(31 citation statements)

References 10 publications

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“…Boyle 16 was able to demonstrate a graded, age-adjusted linear increase in both SBP and DBP with increasing skin darkness among black men and women participating in the Charleston Heart Study. However, in 2 follow-up studies of this cohort, Keil et al 17,18 found no association between skin color and the incidence of hypertension after controlling for either education or other measures of social class. After adjusting for 20 found a significant association between skin darkness and SBP in black men and women.…”

Section: Discussionmentioning

confidence: 66%

Relationship Between Skin Color and Blood Pressure in Egyptian Adults

et al. 2000

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Abstract-In many, but not all societies, dark skin color is associated with high blood pressure. Whether the association between skin color and blood pressure is independent of known determinants of blood pressure remains controversial. We examined the association between skin color and blood pressure in 835 Egyptian adults (370 men and 465 women) participating in the National Hypertension Project, a national survey of hypertension prevalence and blood pressurerelated complications conducted in Egypt during 1991-1993. Skin color was assessed by measuring the concentration of cutaneous melanin in an unexposed area with the use of reflectance spectrophotometry. Higher concentrations of melanin were associated with lower body mass index, less education, manual labor (among men), and a lower urinary sodium-to-potassium ratio (among women). In multivariate regression analyses adjusted for age, body mass index, and education, there was a significant nonlinear association between blood pressure and skin color among women; in the lower to intermediate range of skin pigmentation, both systolic and diastolic blood pressures were higher in women with greater concentrations of cutaneous melanin. In men, blood pressure was not associated with skin color. When we used a subjective assessment of skin color, there was no significant difference in blood pressure between black-skinned Egyptians (predominantly of Nubian descent) and fair-skinned Egyptians for either gender. While the significant relationship in women appeared to be independent of known risk factors for hypertension, residual confounding may explain the association. (Hypertension. 2000;36:296-302.)

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Section: Discussionmentioning

confidence: 66%

Relationship Between Skin Color and Blood Pressure in Egyptian Adults

et al. 2000

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“…In the NHANES I Study, 12 income was not a significant predictor of hypertension in black men or any other sex-race group. However, in the Charleston Heart Study, 16 the incidence of hypertension was greater in black men categorised as being of low social class compared to men of higher social class.…”

Section: Discussionmentioning

confidence: 85%

“…Lifestyle factors as well as syndrome X variables were found to be predictors of EBP, with generally stronger associations for both sets of variables for white men and women compared to black men and women. While several lifestyle factors are considered risk factors for hypertension, including overweight and obesity, physical inactivity, and excessive alcohol consumption, [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] and heart rate and cigarette smoking have been positively related to incidence of hypertension, 3,[5][6][7][8]12,14,[16][17][18] and education inversely related, 12 only four prospective studies have examined one or more of these variables as predictors of hypertension in black subjects 9,12,16 or women. 8,9,12 Similarly, while several prospective studies have examined one or more syndrome X variables as predictors of hypertension, Results for age through cigarette smoker are from models that included only these eight variables; results for insulin, triglycerides, uric acid, and HDL cholesterol are from models that included the first eight variables, plus the individual syndrome X variable.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] Heart rate and cigarette smoking have also been positively related to incidence of hypertension, 3,[5][6][7][8]12,14,[16][17][18] although cigarette smoking has generally been inversely related to blood pressure (BP) in cross-sectional studies. [19][20][21][22][23][24][25][26][27] Education and social status have been inversely related to BP and hypertension in both cross-sectional and prospective studies.…”

Section: Introductionmentioning

confidence: 99%

“…[19][20][21][22][23][24][25][26][27] Education and social status have been inversely related to BP and hypertension in both cross-sectional and prospective studies. 12,16,23,28,29 Only four prospective studies examined one or more of these variables as possible risk factors for hypertension separately in black subjects 9,12,16 or women. 8,9,12 Hence, even though there is a consensus that overweight and obesity, physical inactivity, and excessive alcohol intake are risk factors for hypertension, there is a paucity of data on these lifestyle factors, and on heart rate, cigarette smoking, and education level, as predictors in black subjects and women.…”

Section: Introductionmentioning

confidence: 99%

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Ten-year incidence of elevated blood pressure and its predictors: The CARDIA Study

et al. 1999

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Few prospective studies have examined associations of lifestyle factors or variables in the insulin resistance syndrome (syndrome X) with incidence of elevated blood pressure (BP) in black subjects and women. This report estimates the 10-year incidence of high blood pressure (HBP) and high normal blood pressure (HNBP) in the biracial cohort of the Coronary Artery Risk Development in (Young) Adults Study (CARDIA), and examines lifestyle factors and four syndrome X variables, measured at baseline, as predictors. CARDIA examined 5115 black and white men and women aged 18-30 years in 1985-1986, and re-examined them at 2, 5, 7, and 10 years. The 10-year incidence of HBP was 16.4% in black men, 7.8% in white men, 13.1% in black women, and 3.2% in white women, while the 10-year incidence of HBP or HNBP was 29.5%, 16.2%, 19.2%, and 6.3%, respectively, in the four sex-race subgroups. Predictors included body mass index, waist circumference, physi-

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The Association of Skin Color With Blood Pressure in US Blacks With Low Socioeconomic Status

Klag

Whelton

Coresh

et al. 1991

JAMA

135

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To determine the association of skin color, measured by a reflectometer, with blood pressure in US blacks, we studied a community sample of 457 blacks from three US cities. Persons taking antihypertensive medications were excluded. Both systolic and diastolic blood pressure were higher in darker persons and increased by 2 mm Hg for every 1-SD increase in skin darkness. However, the association was dependent on socioeconomic status, whether measured by education or an index consisting of education, occupation, and ethnicity, being present only in person with lower levels of either indicator. Using multiple linear regression, both systolic and diastolic blood pressure remained significantly associated with darker skin color in the lower levels of socioeconomic status, independent of age, body mass index, and concentrations of blood glucose, serum urea nitrogen, serum uric acid, and urinary sodium and potassium. The association of skin color with blood pressure only in low socioeconomic strata may be due to the lesser ability of such groups to deal with the psychosocial stress associated with darker skin color. However, these findings also are consistent with an interaction between an environmental factor associated with low socioeconomic status and a susceptible gene that has a higher prevalence in persons with darker skin color.

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Hypertension: effects of social class and racial admixture: the results of a cohort study in the black population of Charleston, South Carolina.

Cited by 97 publications

References 10 publications

Relationship Between Skin Color and Blood Pressure in Egyptian Adults

Relationship Between Skin Color and Blood Pressure in Egyptian Adults

Ten-year incidence of elevated blood pressure and its predictors: The CARDIA Study

The Association of Skin Color With Blood Pressure in US Blacks With Low Socioeconomic Status

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