Hypertension in black people: study of specific genotypes and phenotypes will provide a greater understanding of interindividual and interethnic variability in blood pressure regulation than studies based on race

Stein, C. Michael; Lang, Carmen; Xie, Hong‐Guang; Wood, Alastair J.J.

doi:10.1097/00008571-200103000-00001

Cited by 30 publications

(18 citation statements)

References 160 publications

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“…Our findings could provide a clue to the higher incidence of hypertension in AA and suggest why ethnicity-related differences in the prevalence of hypertension are already noted by age 25 (14). Our results demonstrate a decrease of parasympathetic activity rather than an increase of sympathetic activity in younger AA.…”

Section: Discussionsupporting

confidence: 55%

“…In addition, cardiovascular diseases are not only more prevalent in AA but also present at an earlier age compared with CA (13,14). Differences in autonomic nervous system activity might help explain these age and ethnicity differences in cardiovascular disease prevalence and onset.…”

Section: Discussionmentioning

confidence: 99%

“…In spectral analysis of HRV, a decrease in both LF and HF bands with increasing age has been demonstrated (11,12). A significant ethnic difference has been documented between African Americans (AA) and Caucasian Americans (CA) in the prevalence of hypertension (13,14). The existence of greater sympathetic outflow in AA, as a potential mechanism for enhanced cardiovascular response, and consequently hypertension, has often been suggested (15,16).…”

Section: Introductionmentioning

confidence: 99%

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Age and Ethnicity Differences in Short-Term Heart-Rate Variability

Choi

Hong

Nelesen

et al. 2006

Psychosomatic Medicine

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Section: Discussionsupporting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Age and Ethnicity Differences in Short-Term Heart-Rate Variability

Choi

Hong

Nelesen

et al. 2006

Psychosomatic Medicine

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“…Finally, population stratification may confound the differential effects of particular genotypes [25], and this may be problematic within the African American population because of genetic admixture [20]; however, using GAMOVA [21] at 86 biallelic loci, we did not find any significant relationship between population stratification and blood pressure response (P = 0.34).…”

Section: Study Limitations and Population Stratificationmentioning

confidence: 62%

Angiotensin-converting enzyme gene polymorphism predicts the time-course of blood pressure response to angiotensin converting enzyme inhibition in the AASK trial

Bhatnagar

O’Connor

Schork

et al. 2007

Journal of Hypertension

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Objective-It has yet to be determined whether genotyping at the angiotensin-converting enzyme (ACE) locus is predictive of blood pressure response to an ACE inhibitor.Methods-Participants from the African American Study of Kidney Disease and Hypertension trial randomized to the ACE inhibitor ramipril (n = 347) were genotyped at three polymorphisms on ACE, just downstream from the ACE insertion/deletion polymorphism (Ins/Del): G12269A, C17888T, and G20037A. Time to reach target mean arterial pressure (≤ 107 mmHg) was analyzed by genotype and ACE haplotype using Kaplan-Meier survival curves and Cox proportional hazard models.Results-Individuals with a homozygous genotype at G12269A responded significantly faster than those with a heterozygous genotype; the adjusted (average number of medications and baseline mean arterial pressure) hazard ratio (homozygous compared to heterozygous genotype) was 1.86 (95% confidence limits 1.32-3.23; P < 0.001 for G12269A genotype). The adjusted hazard ratio for participants with homozygous ACE haplotypes compared to those heterozygous ACE haplotypes was 1.40 (1.13-1.75; P = 0.003 for haplotype). The ACE genotype effects were specific for ACE inhibition (i.e., not seen among those randomized to a calcium channel blocker), and were independent of population stratification.Conclusions-African-Americans with a homozygous genotype at G12269A or homozygous ACE haplotypes responded to ramipril significantly faster than those with a heterozygous genotype or heterozygous haplotypes, suggesting that heterosis may be an important determinant of responsiveness to an ACE inhibitor. These associations may be a result of biological activity of this polymorphism, or of linkage disequilibrium with nearby variants such as the ACE Ins/Del, perhaps in the regulation of ACE splicing.Correspondence to Vibha Bhatnagar, MD, MPH, VA San Diego Healthcare System,

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“…Not only does HT occur more frequently, but it also presents at an earlier age and causes increased complications of cardiovascular diseases compared with white Americans (57). Although the general prevalence of hypertension has decreased among all genders and ethnic groups in the United States, recent reports indicate that HT now ranks as the 13th leading cause of death in the Unites States, having moved up from its former 15th place.…”

mentioning

confidence: 99%

Low arterial compliance in young African-American males

Zion

Bond

Adams

et al. 2003

American Journal of Physiology-Heart and Circulatory Physiology

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Hypertension remains a common public health challenge because of its prevalence and increase in co-morbid cardiovascular diseases. Black males have disproportionate pathophysiological consequences of hypertension compared with any other group in the United States. Alterations in arterial wall compliance and autonomic function often precede the onset of disease. Accordingly, our purpose was to investigate whether differences exist in arterial compliance and autonomic function between young, healthy African-American males without evidence of hypertension and age- and gender-matched non-African-American males. All procedures were carried out noninvasively following rest. Arterial compliance was calculated as the integrated area starting at the well-defined nadir of the incisura of the dicrotic notch to the end of diastole of the radial artery pulse wave. Power spectral analysis of heart rate and blood pressure variability provided distributions representative of parasympathetic and sympathetic modulations and sympathovagal balance. Baroreflex sensitivity (BRS) was calculated using the sequence method. Thirty-two African-American and twenty-nine non-African-American males were comparable in anthropometrics and negative family history of hypertension. t-Tests revealed lower arterial compliance (5.8 ± 2.4 vs. 8.6 ± 4.0 mmHg · s; P = 0.0017), parasympathetic modulation (8.9 ± 1.1 vs. 9.7 ± 1.1 ln ms2; P = 0.0063), and BRS (13.7 ± 7.3 vs. 21.1 ± 8.5 ms/mmHg; P = 0.0007) and higher sympathovagal balance (2.9 ± 3.2 vs. 1.5 ± 1.1; P = 0.03) in the African-American group. In summary, differences exist in arterial compliance and autonomic balance in African-American males. These alterations may be antecedent markers of disease and valuable in the detection of degenerative cardiovascular processes in individuals at risk.

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Hypertension in black people: study of specific genotypes and phenotypes will provide a greater understanding of interindividual and interethnic variability in blood pressure regulation than studies based on race

Cited by 30 publications

References 160 publications

Age and Ethnicity Differences in Short-Term Heart-Rate Variability

Age and Ethnicity Differences in Short-Term Heart-Rate Variability

Angiotensin-converting enzyme gene polymorphism predicts the time-course of blood pressure response to angiotensin converting enzyme inhibition in the AASK trial

Low arterial compliance in young African-American males

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