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| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:issue |
3
|
| pubmed:dateCreated |
1996-10-22
|
| pubmed:abstractText |
It is frequently stated that the risk of sequelae from hypertension at a given level of severity is higher among blacks than whites, although little empirical evidence supports that supposition. In this work we examined the basis for accepting the existence of a black: white differential in hypertension outcomes in a representative biracial sample of the U.S. population followed in the First National Health and Nutrition Examination Survey (NHANES-1) Epidemiologic Follow-up Study. As well recognized, the risk associated with increasing blood pressure is not dichotomous but varies across the entire distribution in a curvilinear fashion. The rightward skew of the blood pressure distribution with increasing mean levels affects comparisons between populations, since the change in shape results in a change in the mix of case severity. These considerations can influence estimates of the relative population-attributable risk from hypertension, considered as a dichotomous classification in blacks and whites. Although the relative risk of death associated with a systolic blood pressure of > or = 140 mmHg in this study was higher for blacks than for whites (1.7 and 1.5, respectively), with all-cause mortality as the outcome, the logistic coefficient for systolic blood pressure was not significantly different among white as compared with black men (beta = 0.016 vs. 0.010; p = 0.320 for race interaction term) and was slightly greater among white vs. black women (beta = 0.013 vs. 0.010; P = 0.05). After strata-specific blood pressure adjustment, the principal determinant of increased population risk for both black men and women was the higher prevalence of hypertension, not differential severity. The population-attributable risk for hypertension was at least two times higher among blacks because of the higher prevalence among them; moreover, the increased prevalence accounted for 10% of the interethnic difference in mortality. Data from this study indicate that hypertension was not more severe among individual blacks, simply more common in the population.
|
| pubmed:grant | |
| pubmed:commentsCorrections | |
| pubmed:language |
eng
|
| pubmed:journal | |
| pubmed:citationSubset |
IM
|
| pubmed:status |
MEDLINE
|
| pubmed:month |
May
|
| pubmed:issn |
1047-2797
|
| pubmed:author | |
| pubmed:issnType |
Print
|
| pubmed:volume |
6
|
| pubmed:owner |
NLM
|
| pubmed:authorsComplete |
Y
|
| pubmed:pagination |
173-80
|
| pubmed:dateRevised |
2008-6-23
|
| pubmed:meshHeading |
pubmed-meshheading:8827151-Adult,
pubmed-meshheading:8827151-African Continental Ancestry Group,
pubmed-meshheading:8827151-Aged,
pubmed-meshheading:8827151-Blood Pressure,
pubmed-meshheading:8827151-Cardiovascular Diseases,
pubmed-meshheading:8827151-Data Interpretation, Statistical,
pubmed-meshheading:8827151-Databases, Factual,
pubmed-meshheading:8827151-European Continental Ancestry Group,
pubmed-meshheading:8827151-Female,
pubmed-meshheading:8827151-Follow-Up Studies,
pubmed-meshheading:8827151-Humans,
pubmed-meshheading:8827151-Hypertension,
pubmed-meshheading:8827151-Logistic Models,
pubmed-meshheading:8827151-Male,
pubmed-meshheading:8827151-Middle Aged,
pubmed-meshheading:8827151-Prevalence,
pubmed-meshheading:8827151-Risk Factors,
pubmed-meshheading:8827151-Severity of Illness Index,
pubmed-meshheading:8827151-Sex Factors,
pubmed-meshheading:8827151-United States
|
| pubmed:year |
1996
|
| pubmed:articleTitle |
Is hypertension more severe among U.S. blacks, or is severe hypertension more common?
|
| pubmed:affiliation |
Department of Preventive Medicine and Epidemiology, Loyola University Stritch School of Medicine, Maywood, Illinois 60153, USA.
|
| pubmed:publicationType |
Journal Article,
Comparative Study,
Research Support, U.S. Gov't, P.H.S.
|