Cited by 1,366Blood Pressure and Hypertension StudiesSodium Intake and HealthCardiovascular Health and Disease Prevention

Panethnic Differences in Blood Pressure in Europe: A Systematic Review and Meta-Analysis

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Modesti, Pietro Amedeo, Reboldi, Gianpaolo, Cappuccio, Francesco P., Agyemang, Charles, Remuzzi, Giuseppe, Rapi, Stefano, Perruolo, Eleonora, Parati, Gianfranco +1 more·2016·PLOS ONE

Abstract

BACKGROUND: People of Sub Saharan Africa (SSA) and South Asians(SA) ethnic minorities living in Europe have higher risk of stroke than native Europeans(EU). Study objective is to provide an assessment of gender specific absolute differences in office systolic(SBP) and diastolic(DBP) blood pressure(BP) levels between SSA, SA, and EU. METHODS AND FINDINGS: We performed a systematic review and meta-analysis of observational studies conducted in Europe that examined BP in non-selected adult SSA, SA and EU subjects. Medline, PubMed, Embase, Web of Science, and Scopus were searched from their inception through January 31st 2015, for relevant articles. Outcome measures were mean SBP and DBP differences between minorities and EU, using a random effects model and tested for heterogeneity. Twenty-one studies involving 9,070 SSA, 18,421 SA, and 130,380 EU were included. Compared with EU, SSA had higher values of both SBP (3.38 mmHg, 95% CI 1.28 to 5.48 mmHg; and 6.00 mmHg, 95% CI 2.22 to 9.78 in men and women respectively) and DBP (3.29 mmHg, 95% CI 1.80 to 4.78; 5.35 mmHg, 95% CI 3.04 to 7.66). SA had lower SBP than EU(-4.57 mmHg, 95% CI -6.20 to -2.93; -2.97 mmHg, 95% CI -5.45 to -0.49) but similar DBP values. Meta-analysis by subgroup showed that SA originating from countries where Islam is the main religion had lower SBP and DBP values than EU. In multivariate meta-regression analyses, SBP difference between minorities and EU populations, was influenced by panethnicity and diabetes prevalence. CONCLUSIONS: 1) The higher BP in SSA is maintained over decades, suggesting limited efficacy of prevention strategies in such group in Europe;2) The lower BP in Muslim populations suggests that yet untapped lifestyle and behavioral habits may reveal advantages towards the development of hypertension;3) The additive effect of diabetes, emphasizes the need of new strategies for the control of hypertension in groups at high prevalence of diabetes.

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  1. [23]Higgins J, Green SP (2008) Cochrane handbook for systematic reviews of interventions. Oxford: Wiley-Blackwell.
  2. [74]Barba C, Cavalli-Sforza T, Cutter J, Darnton-Hill I, Deurenberg P, Deurenberg-Yap M, et al (2004) Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 363: 157– 163. 14726171

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Authors
Modesti, P. A., Reboldi, G., Cappuccio, F. P., Agyemang, C., Remuzzi, G., Rapi, S., Perruolo, E., Parati, G., & ESH Working Group on CV Risk in Low Resource Settings
Affiliations
  • University of Florence (IT)
  • University of Perugia (IT)
  • University Hospital Coventry (GB)
  • University of Amsterdam (NL)
  • Mario Negri Institute for Pharmacological Research (IT)
  • IRCCS Istituto Auxologico Italiano (IT)
Corresponding author
Modesti, Pietro Amedeo
Venue
PLOS ONE
Published
2016-01-25
Volume
11
Issue
1
Pages
e0147601
ISSN
1932-6203 (ISSN-L)
OpenAlex
W2257818166
Cited by
1,366
References
83
Citations by year
2026: 104 · 2025: 146 · 2024: 164 · 2023: 179 · 2022: 220 · 2021: 240 · 2020: 185 · 2019: 76 · 2018: 39 · 2017: 7 · 2016: 5
FWCI
7.48
Type
journal article
Language
en
Open access
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Warwick Research Archive Portal (University of Warwick) (acceptedVersion)
  • Florence Research (University of Florence) (submittedVersion, cc-by-nc-nd)
  • Pure Amsterdam UMC (submittedVersion, other-oa)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
  • CINECA IRIS Institutial research information system (University of Pisa) (submittedVersion, cc-by)
  • BOA (University of Milano-Bicocca) (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Figshare (submittedVersion, cc-by)
  • Lund University Publications (Lund University) (submittedVersion)
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
blood pressure, ethnic minorities in Europe, sub-Saharan Africans, South Asians, hypertension, systolic blood pressure, diastolic blood pressure, panethnicity, Islam, diabetes prevalence, stroke risk, gender differences, lifestyle factors, hypertension prevention, Muslim population
MeSH terms
Adult, Blood Pressure, Ethnicity, Europe, Female, Humans, Male

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