Hypertension in Blacks

1

What is the prevalence of hypertension in Blacks in the United States?

According to (the National Health and Nutrition Examination Survey from 2017–18, the age-adjusted prevalence of hypertension in adults was noted to be higher in non-Hispanic Blacks (57.1%) as compared with non-Hispanic Whites (43.6%) and Hispanics (43.7%). When looking at men and women separately, the age-adjusted prevalence of hypertension was also found to be higher in non-Hispanic Blacks as compared with non-Hispanic Whites and Hispanics. The definition of hypertension used in this survey was a cut off of blood pressure (BP) of 130/80 mm Hg or greater or taking medication for hypertension. The previous guidelines used a definition of 140/90 mm Hg. Interestingly, with this new definition of BP goal of less than 130/80 mm Hg (according to the 2017 American Heart Association and American College of Cardiology guidelines), 3.5 million more Black men would fit the definition of having hypertension ( Fig. 21.1 ).

2

Does hypertension have an earlier age of onset in Blacks in comparison to Whites?

The number of children and adolescents with hypertension is relatively small, and to get meaningful comparative data is difficult. We do know that BPs are, on average, significantly higher in normotensive Black children than in normotensive White children.

There is an increased number of Blacks who develop hypertension by middle age when compared with their White counterparts. According to the findings of the (Coronary Artery Risk Development in Young Adults study published in 2018, three in four Black men and women were likely to have hypertension by age 55 in contrast to 55% of White men and 40% of White women by the same age.

3

How does the hypertension in Blacks compare with the hypertension in Whites?

Compared to all other population groups, for Blacks the risk for hypertension is greater, and the likelihood of developing serious complications such as stroke, heart failure, or end-stage renal disease is increased considerably.

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