Hypertension : Cultural and ethnic health disparities

  • Cultural and ethnic health disparities
    • African Americans
      • Have the highest prevalence of hypertension in the world
      • Develop hypertension at a younger age than whites
      • Have a higher incidence of hypertension among women than among men
      • Demonstrate more nocturnal non-dipping BP than whites
      • Hypertension is more aggressive and results in more severe end-organ damage.
      • Have a higher death rate resulting from hypertension than whites
      • Produce less renin and do not respond well to renin-inhibiting drugs
      • Calcium channel blockers and diuretics provide better BP control, especially with monotherapy.
      • Have a higher risk of angioedema with angiotensin-converting enzyme inhibitors than whites
    • Mexican Americans
      • Are less likely to receive treatment for hypertension than whites and African Americans
      • Have lower rates of BP control than whites and African Americans
      • Have lower levels of awareness of hypertension and its treatment than whites and African Americans
  • Gender differences
    • Men
      • Before early middle age, hypertension is more common in men than in women.
    • Women
      • Hypertension is two to three times more common in women who take oral contraceptives than in women who do not.
      • A history of preeclampsia may be an early sign of risk for cardiovascular disease.
      • After age 64, hypertension is more common in women than in men. Part of the rise in BP in women is attributed to menopause related factors such as estrogen withdrawal, overproduction of pituitary hormones, and weight gain.
      • It is more difficult to control hypertension in older women (ages 70-79) than in women ages 50-69, despite having similar rates of treatment.