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Cited by 124Blood Pressure and Hypertension StudiesSodium Intake and HealthCardiovascular Health and Disease Prevention

Progression Is Accelerated From Prehypertension to Hypertension in Blacks

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Selassie, Anbesaw, Wagner, C. Shaun, Laken, Marilyn L., Ferguson, M. LaFrance, Ferdinand, Keith C., Egan, Brent M.·2011·Hypertension
DOI 10.1161/hypertensionaha.111.177410PMC PMC3186683
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Abstract

Prehypertension is a major risk factor for hypertension. Blacks have more prevalent and severe hypertension than whites, but it is unknown whether progression from prehypertension is accelerated in blacks. We examined this question in a prospective cohort study of 18 865 nonhypertensive persons (5733 black [30.4%] and 13 132 white [69.6%]) aged 18 to 85 years. Electronic health record data were obtained from 197 community-based outpatient clinics in the Southeast United States. Days elapsing from study entry to hypertension diagnosis, mainly blood pressure ≥140 mm Hg systolic and/or ≥90 mm Hg diastolic on 2 consecutive visits established conversion time within a maximum observation period of 2550 days. Cox regression modeling was used to examine conversion to hypertension as a function of race, while controlling for age, sex, baseline systolic and diastolic blood pressures, body mass index, diabetes mellitus, and chronic kidney disease. The covariable adjusted median conversion time when 50% became hypertensive was 365 days earlier for blacks than whites (626 versus 991 days; P <0.001). Among covariables, baseline systolic blood pressure 130 to 139 mm Hg (hazard ratio: 1.77 [95% CI: 1.69 to 1.86]) and 120 to 129 mm Hg (hazard ratio: 1.52 [95% CI: 1.44 to 1.60]), as well as age ≥75 years (hazard ratio: 1.40 [95% CI: 1.29 to 1.51]) and 55 to 74 years (hazard ratio: 1.29 [95% CI: 1.23 to 1.35]) were the strongest predictors of hypertension. Additional predictors included age 35 to 54 years, diastolic blood pressure 80 to 89 mm Hg, overweight and obesity, and diabetes mellitus (all P <0.001). Conversion from prehypertension to hypertension is accelerated in blacks, which suggests that effective interventions in prehypertension could reduce racial disparities in prevalent hypertension.

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  • Excess adiposity is the strongest known risk factor for hypertension in male and female subjects of different ages and races.

    “The close relationship between excess adipose mass and hypertension is well documented, with population-based studies showing excess adiposity as the strongest known risk factor for hypertension in male and female subjects of different ages and races (1–5).”

    From Obesity-Associated Hypertension: Recent Progress in Deciphering the Pathogenesis (2014) · cites this paper as [4]

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Research works printed but not linked: 3

  1. [22]Breslow NE Day NE Modelling the relaionship between risk, dose, and time International Agency for Research on Cancer Statistical Method In Cancer Research: The Design and Analysis of Cohort Data Lyon, France Oxford University Press 1987 232 70
  2. [23]Greenland S Applications of Stratified Analysis Methods Rothman KJ G S L T Modern Epidemiology 3rd Philadelphia, USA Lippincott Williams & Wilkins 2008 283 302
  3. [24]Egan BM Should metabolic syndrome patients with prehypertension receive antihypertensive therapy? Bakris G Oxford, UK Clinical Publishing 2006 9 25

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Related

Authors
Selassie, A., Wagner, C. S., Laken, M. L., Ferguson, M. L., Ferdinand, K. C., & Egan, B. M.
Affiliations
Emory University (US)
ORCID
Venue
Hypertension
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2011-10
Volume
58
Issue
4
Pages
579-587
ISSN
  • 0194-911X (ISSN-L)
  • 1524-4563
DOI
10.1161/hypertensionaha.111.177410
PMC
PMC3186683
OpenAlex
W2135286363
Cited by
124
References
46
Citations by year
2026: 2 · 2025: 4 · 2024: 6 · 2023: 8 · 2022: 7 · 2021: 5 · 2020: 10 · 2019: 7 · 2018: 8 · 2017: 15 · 2016: 11 · 2015: 12 · 2014: 6 · 2013: 11 · 2012: 10
FWCI
6.36
Type
journal article
Language
en
Open access
Locations
  • Hypertension (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Heart, Lung, and Blood Institute (R01HL091841, HL091841)
  • National Institute of Diabetes and Digestive and Kidney Diseases (R01DK067615, DK067615)
  • National Center for Research Resources (UL1RR029882)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
  • Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
Keywords
prehypertension, racial disparities, African Americans, blood pressure, hypertension progression, baseline systolic blood pressure, age, obesity, diabetes mellitus, chronic kidney disease, body mass index
MeSH terms
Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Black or African American, Female, Humans, Hypertension, Male, Middle Aged, Obesity, Prospective Studies, Risk Factors, Southeastern United States, Cohort Studies, Prevalence, Disease Progression, Black People, White People, Diabetes Complications, Overweight, Young Adult, Prehypertension

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