Objectives
Blood pressures in persons of African descent exceed those of other racial/ethnic groups in the US. Whether this trait is attributable to genetic factors in African-origin populations, or a result of inadequately measured environmental exposures, such as racial discrimination, is not known. To study this question we conducted a multi-site comparative study of communities in the African diaspora, drawn from metropolitan Chicago, Kingston, Jamaica, rural Ghana, Cape Town, South Africa, and the Seychelles.
Methods
At each site 500 participants between the ages of 25 and 49, with approximately equal sex balance, were enrolled for a longitudinal study of energy expenditure and weight gain. In this report we describe the patterns of blood pressure and hypertension observed at baseline among the sites.
Results
Mean systolic and diastolic blood pressures were very similar in the US and South Africa in both men and women, although among women the prevalence of hypertension was higher in the US (24 vs. 17%, respectively). After adjustment for multiple covariates, relative to participants in the U.S., systolic blood pressure was significantly higher among South Africans by 9.7 mmHg (p<0.05) and significantly lower for each of the other sites: viz, Jamaica, −7.9 mmHg (p=0.06), Ghana, −12.8 mmHg (p<0.01), Seychelles, −11.1 mmHg (p=0.01).
Conclusion
These data are consistent with prior findings of a blood pressure gradient in societies of the African diaspora and confirm that African-origin populations with lower social status in multi-racial societies, such as the US and South Africa, experience more hypertension than anticipated based on anthropometric and measurable socioeconomic risk factors.