Key result
West African migrants had significantly lower hypertension control rates compared to the Dutch host population (44.3% vs 58.0%, p < 0.001), and specific antihypertensive medication categories were not associated with better control.
Why the study?
Guidelines recommend diuretics and/or calcium channel blockers for African migrants, but data on antihypertensive medication prescription patterns or related hypertension control rates are lacking.
Does the category of antihypertensive medication prescribed affect hypertension control in West African migrants compared to the Dutch host population?
Cross-Sectional (n=1,313)
Does the category of antihypertensive medication prescribed affect hypertension control in West African migrants compared to the Dutch host population?
Despite higher prescription rates of guideline-recommended calcium channel blockers in West African migrants compared to the Dutch host population, hypertension control remains significantly poorer and is not improved by specific antihypertensive classes.
AHM patterns in WA migrants may diverge from guidelines; leaves open optimal regimens for control in this population.
West African (WA) migrants in Europe have higher hypertension rates than the host populations. For African migrants, guidelines recommend diuretics and/or calcium channel blockers (CCB) for primary cardiovascular disease prevention, but data on antihypertensive medication (AHM) prescription patterns or related hypertension control rates are lacking. We assessed AHM prescription patterns and its relation to hypertension control among hypertensive WA migrants in the Netherlands compared to the host population. Cross-sectional data from WA or Dutch origin participants from the HELIUS study were used. Participants with treated hypertension and without diabetes, cardiovascular disease, or microalbuminuria were selected. We used logistic and linear regression analyses to assess the association between AHM categories and hypertension control rates (systolic blood pressure (BP) ≤ 140 mmHg and diastolic BP ≤ 90 mmHg) and the systolic BP levels. We compared 999 WA participants and 314 Dutch participants. Hypertension control rates were lower in the WA origin compared to Dutch origin participants (44.3% versus 58.0%, p < 0.001). For WA participants, prescription rates for any AHM category were: CCB (54.8%), diuretics (18.5%) beta-blocking agents (27.3%) and renin-angiotensin system blockers (52.6%). Prescription rates were higher for CCB and similar for diuretics compared to the Dutch participants. Neither CCB nor diuretics were associated with better control rates. Compared to Dutch participants, West African participants had similar diuretic prescriptions but significantly higher prescriptions for CCB. However, neither medications was associated with better hypertension control. Future research should explore physician and patient factors to improve hypertension control.
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Apeldoorn et al. (2024) conducted a cross-sectional in Hypertension (n=1,313). West African ethnicity and antihypertensive medication categories vs. Dutch host population and other antihypertensive medication categories was evaluated on Hypertension control (systolic blood pressure ≤ 140 mmHg and diastolic blood pressure ≤ 90 mmHg) (p=<0.001). West African migrants had significantly lower hypertension control rates compared to the Dutch host population (44.3% vs 58.0%, p < 0.001), and specific antihypertensive medication categories were not associated with better control.
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