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Racial/ethnic differences in hypertension and hypertension treatment and control in the multi-ethnic study of atherosclerosis (MESA).
Am J Hypertens 2004; 17(10):963-70AJ

Abstract

BACKGROUND

Most previous studies investigating the association between ethnicity and hypertension focused on differences between African Americans and whites and did not include other racial/ethnic groups such as Chinese or Hispanics.

METHODS

We used data from the Multi-Ethnic Study of Atherosclerosis (MESA), a population-based study of 6814 adults without clinical cardiovascular disease, to examine the association between ethnicity and hypertension and hypertension treatment among white, African American, Chinese, and Hispanic ethnic groups.

RESULTS

The prevalence of hypertension, defined as systolic blood pressure (BP) <140 mm Hg and diastolic BP <90 mm Hg or self-reported treatment for hypertension, was significantly higher in African Americans compared to whites (60% v 38%; P < .0001), whereas prevalence in Hispanic (42%) and Chinese participants (39%) did not differ significantly from that in whites. After adjustment for age, body mass index, prevalence of diabetes mellitus, and smoking, African American (odds ratio [OR] 2.21; 95% confidence interval [95% CI] 1.91-2.56) and Chinese (OR 1.30; 95% CI 1.07-1.56) ethnicity were significantly associated with hypertension compared to whites. Among hypertensive MESA participants, the percentage of treated but uncontrolled hypertension in whites (24%) was significantly lower than in African Americans (35%, P < .0001), Chinese (33%, P = .003), and Hispanics (32%, P = .0005), but only African-American race/ethnicity remained significantly associated with treated but uncontrolled hypertension after controlling for socioeconomic factors (OR 1.35; 95% CI 1.07-1.71). Diuretic use was lowest in the Chinese (22%) and Hispanic participants (32%) and was significantly lower in these groups compared with white participants (47%; P < .0001 for both comparisons).

CONCLUSIONS

Programs to improve hypertension treatment and control should focus on a better understanding of differences in the prevalence of hypertension and hypertension control among minority groups in the United States, especially African Americans, compared with whites, and on techniques to prevent hypertension and improve control in high-risk groups.

Authors+Show Affiliations

Department of Preventive Medicine, Loyola University, Chicago, Illinois, USA. hkramer@lumc.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15485761

Citation

Kramer, Holly, et al. "Racial/ethnic Differences in Hypertension and Hypertension Treatment and Control in the Multi-ethnic Study of Atherosclerosis (MESA)." American Journal of Hypertension, vol. 17, no. 10, 2004, pp. 963-70.
Kramer H, Han C, Post W, et al. Racial/ethnic differences in hypertension and hypertension treatment and control in the multi-ethnic study of atherosclerosis (MESA). Am J Hypertens. 2004;17(10):963-70.
Kramer, H., Han, C., Post, W., Goff, D., Diez-Roux, A., Cooper, R., ... Shea, S. (2004). Racial/ethnic differences in hypertension and hypertension treatment and control in the multi-ethnic study of atherosclerosis (MESA). American Journal of Hypertension, 17(10), pp. 963-70.
Kramer H, et al. Racial/ethnic Differences in Hypertension and Hypertension Treatment and Control in the Multi-ethnic Study of Atherosclerosis (MESA). Am J Hypertens. 2004;17(10):963-70. PubMed PMID: 15485761.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Racial/ethnic differences in hypertension and hypertension treatment and control in the multi-ethnic study of atherosclerosis (MESA). AU - Kramer,Holly, AU - Han,Cong, AU - Post,Wendy, AU - Goff,David, AU - Diez-Roux,Ana, AU - Cooper,Richard, AU - Jinagouda,Sujata, AU - Shea,Steven, PY - 2004/03/09/received PY - 2004/05/12/revised PY - 2004/06/01/accepted PY - 2004/10/16/pubmed PY - 2005/1/26/medline PY - 2004/10/16/entrez SP - 963 EP - 70 JF - American journal of hypertension JO - Am. J. Hypertens. VL - 17 IS - 10 N2 - BACKGROUND: Most previous studies investigating the association between ethnicity and hypertension focused on differences between African Americans and whites and did not include other racial/ethnic groups such as Chinese or Hispanics. METHODS: We used data from the Multi-Ethnic Study of Atherosclerosis (MESA), a population-based study of 6814 adults without clinical cardiovascular disease, to examine the association between ethnicity and hypertension and hypertension treatment among white, African American, Chinese, and Hispanic ethnic groups. RESULTS: The prevalence of hypertension, defined as systolic blood pressure (BP) <140 mm Hg and diastolic BP <90 mm Hg or self-reported treatment for hypertension, was significantly higher in African Americans compared to whites (60% v 38%; P < .0001), whereas prevalence in Hispanic (42%) and Chinese participants (39%) did not differ significantly from that in whites. After adjustment for age, body mass index, prevalence of diabetes mellitus, and smoking, African American (odds ratio [OR] 2.21; 95% confidence interval [95% CI] 1.91-2.56) and Chinese (OR 1.30; 95% CI 1.07-1.56) ethnicity were significantly associated with hypertension compared to whites. Among hypertensive MESA participants, the percentage of treated but uncontrolled hypertension in whites (24%) was significantly lower than in African Americans (35%, P < .0001), Chinese (33%, P = .003), and Hispanics (32%, P = .0005), but only African-American race/ethnicity remained significantly associated with treated but uncontrolled hypertension after controlling for socioeconomic factors (OR 1.35; 95% CI 1.07-1.71). Diuretic use was lowest in the Chinese (22%) and Hispanic participants (32%) and was significantly lower in these groups compared with white participants (47%; P < .0001 for both comparisons). CONCLUSIONS: Programs to improve hypertension treatment and control should focus on a better understanding of differences in the prevalence of hypertension and hypertension control among minority groups in the United States, especially African Americans, compared with whites, and on techniques to prevent hypertension and improve control in high-risk groups. SN - 0895-7061 UR - https://www.unboundmedicine.com/medline/citation/15485761/Racial/ethnic_differences_in_hypertension_and_hypertension_treatment_and_control_in_the_multi_ethnic_study_of_atherosclerosis__MESA__ L2 - https://academic.oup.com/ajh/article-lookup/doi/10.1016/j.amjhyper.2004.06.001 DB - PRIME DP - Unbound Medicine ER -