What question did this study set out to answer?

To evaluate whether the progression from prehypertension to established hypertension occurs faster in Black individuals compared with White individuals.

September 13, 2011HypertensionOpen Access

Progression Is Accelerated From Prehypertension to Hypertension in Blacks

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Why the study?

Is progression from prehypertension to hypertension accelerated in black patients compared to white patients?

Population

18,865 nonhypertensive persons aged 18 to 85 years from 197 community-based outpatient clinics.

Comparison

Black race (exposure) vs White race

Design

Cohort

Follow-up

maximum 2550 days

Authors

ASAnbesaw W. SelassieMedical University of South Carolina CWC. Shaun WagnerUniversity of Minnesota MLMarilyn L. LakenMedical University of South Carolina

Discussion

Member takes

Implication

Black patients with prehypertension may warrant closer monitoring; leaves open whether targeted strategies reduce racial disparities in onset.

Key Points

To evaluate whether the progression from prehypertension to established hypertension occurs faster in Black individuals compared with White individuals.
Prospective cohort study analyzing electronic health record data from 197 community-based outpatient clinics in the Southeast United States, including 18,865 nonhypertensive adults (5,733 Black [30.4%] and 13,132 White [69.6%]) aged 18 to 85 years followed up to 2,550 days.
Hypertension onset was defined primarily as systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg on 2 consecutive visits, evaluated via multivariable Cox proportional hazards regression adjusting for baseline demographics, blood pressure, BMI, diabetes, and chronic kidney disease.
The covariable-adjusted median conversion time to hypertension (50% incidence) was 365 days earlier for Black individuals than White individuals (626 days vs. 991 days; P<0.001).
Baseline systolic blood pressure was the strongest predictor of progression, with hazard ratios of 1.77 (95% CI: 1.69 to 1.86) for 130 to 139 mm Hg and 1.52 (95% CI: 1.44 to 1.60) for 120 to 129 mm Hg.
Older age was also strongly predictive, with hazard ratios of 1.40 (95% CI: 1.29 to 1.51) for age ≥75 years and 1.29 (95% CI: 1.23 to 1.35) for age 55 to 74 years (all P<0.001).

Structured PICO

Is progression from prehypertension to hypertension accelerated in black patients compared to white patients?

Population

18,865 nonhypertensive persons (prehypertension) aged 18 to 85 years (5,733 black [30.4%] and 13,132 white [69.6%]) from 197 community-based outpatient clinics.

Intervention

Black race (exposure)

Comparator

White race

Outcome

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) within a maximum observation period of 2550 days.surrogate

Progression from prehypertension to hypertension is significantly accelerated in black patients compared to white patients, highlighting the need for early intervention to reduce racial disparities.

Cite This Study

Selassie et al. (2011) studied this question.

synapsesocial.com/papers/6a76366fb515f78917fbe361 https://doi.org/10.1161/hypertensionaha.111.177410

Topics

Hypertension management

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Implication

Black patients with prehypertension may warrant closer monitoring; leaves open whether targeted strategies reduce racial disparities in onset.

Progression Is Accelerated From Prehypertension to Hypertension in Blacks

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Progression Is Accelerated From Prehypertension to Hypertension in Blacks

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

Also Consider