Racial/ethnic differences in hypertension and hypertension treatment and control in the multi-ethnic study of atherosclerosis (MESA)

被引:248
作者
Kramer, H
Han, C
Post, W
Goff, D
Diez-Roux, A
Cooper, R
Jinagouda, S
Shea, S
机构
[1] Loyola Univ, Med Ctr, Dept Prevent Med, Maywood, IL 60153 USA
[2] Univ Washington, Sch Publ Hlth, Dept Biostat, Seattle, WA 98195 USA
[3] Johns Hopkins Univ, Sch Med, Dept Med, Baltimore, MD 21205 USA
[4] Wake Forest Univ, Dept Publ Hlth Sci, Sch Med, Winston Salem, NC 27109 USA
[5] Univ Michigan, Sch Publ Hlth, Dept Epidemiol, Ann Arbor, MI 48109 USA
[6] Univ Calif Los Angeles, Sch Med, Dept Epidemiol & Prevent Med, Los Angeles, CA USA
[7] Columbia Univ, Dept Med, New York, NY USA
[8] Columbia Univ, Dept Epidemiol, New York, NY USA
关键词
race; ethnicity; hypertension; hypertension control; MESA;
D O I
10.1016/j.amjhyper.2004.06.001
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
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. (C) 2004 American Journal of Hypertension, Ltd.
引用
收藏
页码:963 / 970
页数:8
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