Hypertension in Cuba: evidence of a narrow black–white difference

Abstract

The Caribbean nation of Cuba is comprised of over 10 million persons who trace their ancestry primarily to Africa and Spain. To date, little data on blood pressure (BP) or hypertension prevalence from Cuba have appeared in English language journals. Because the current government has pursued an active policy of reducing social differentiation on the basis of ethnic origin, Cuba provides an important population laboratory from which to advance the understanding of black-white differences in BP and hypertension. The authors conducted a population-based random sample among adults (aged > 15 years) in the city of Cienfuegos. Overall response rate was 95%, yielding 1633 participants who provided BP readings, self-reported racial group, demographic information, and treatment status. Overall prevalence of hypertension (SBP > or = 140 mm Hg or DBP > or = 90 mm Hg or currently treated) was 44% (46% among blacks and 43% whites; P = 0.19). Excess BP among black subjects was reduced slightly by excluding those under treatment, but attained statistical significance after adjustment for sex and age (P = 0.01). The black-white difference was small, however, relative to that observed in the United States. Racial differences in treatment status and control were also observed. Although there remains a difference in socioeconomic profile between those of African and of European origin in Cuba, this has decreased over recent decades. In the United States, the greater magnitude of social differentiation parallels a greater relative risk of BP elevation among blacks, suggesting that social, economic and psychological factors may play an important role in the observed racial gap in cardiovascular risk.

Blacks and whites in Cuba have equal prevalence of hypertension: confirmation from a new population survey

“…Unfortunately these conditions cannot be found in North America, the UK, or Brazil, where the vast majority of persons in the African Diaspora live. We previously examined racial hypertension differentials in Cuba, a country with a persistently implemented policy of social inclusion stemming from the 1959 revolution, and we found consistent evidence of a diminished prevalence gap between blacks and whites compared to the US [10,11]. We report here findings from a new survey in Cuba confirming an absence of substantial racial differentials in blood pressure.…”

An international comparative study of blood pressure in populations of European vs. African descent

“…On the whole, however, the published literature on racial disparities in hypertension from the UK is less consistent than in the US, where essentially every study has reported higher rates among blacks [28]. Surveys from Cuba, Trinidad and Brazil have also shown a smaller black-white gradient in BP than found in North America [29-31]. …”

Prevalence, awareness, treatment and control of hypertension in Vietnam—results from a national survey

“…[19][20][21][22][23][24][25][26][27][28][29][30][31][32] Other international investigations have studied factors associated with prevalence, awareness, treatment and control of hypertension. [21][22][23][28][29][30][31][33][34][35] Our results are consistent with several previous reports.…”